CO2 laser-assisted posterior semicircular canal ablation for benign paroxysmal positional vertigo.

OBJECTIVES The objective of this study was to analyze a new technique, CO2 laser-assisted posterior semicircular canal ablation (LAPSCCA), in the treatment of refractory benign paroxysmal positional vertigo. STUDY DESIGN Prospective study of patients with disabling BPPV who failed conservative therapy. METHODS Patients noted to have been treated with at least three Epley maneuvers without success and continuing to have disabling symptoms were enrolled in this study. Patients underwent pre- and post-operative electronystagmography. The surgical technique is modified from Parnes1 and involves plugging each end of the fenestrated posterior semicircular canal with bone grafts and fibrin glue. The CO2 fiberoptic (Omniguide) laser is then used at a setting of 2 watts to incise between the cut ends of the canal to completely section the membranous labyrinth. RESULTS All six patients had excellent relief of positional vertigo symptoms. CONCLUSIONS LAPSCCA is an excellent treatment option for patients with intractable BPPV.