Cochlear implantation and simultaneous posterior semicircular canal plugging.

Area of Science:

• Neuroscience
• Otolaryngology
• Surgical Innovation

Background:

• Intractable benign paroxysmal positional vertigo (BPPV) often necessitates surgical intervention, such as plugging the affected semicircular canal (SCC).
• Cochlear implants (CIs) are established treatments for hearing loss and can alleviate subjective tinnitus symptoms.
• Simultaneous surgical interventions for combined audiovestibular conditions are complex and require careful consideration.

Observation:

• A 50-year-old male with single-sided deafness (SSD), severe tinnitus, and intractable posterior SCC (PSCC) BPPV underwent simultaneous ipsilateral CI and PSCC plugging.
• The patient had previously received a bone-anchored hearing system (BAHS) without resolution of his symptoms.
• Initial post-operative outcomes were positive, but tinnitus recurred and worsened after an MRI.

Findings:

• This case represents the first documented instance of concurrent cochlear implantation and ipsilateral PSCC plugging.
• The combined surgical approach demonstrated initial clinical and subjective success in managing both BPPV and tinnitus.
• Despite initial improvement, tinnitus exacerbation occurred post-MRI, highlighting potential complexities.

Implications:

• This combined surgical technique offers a potential new treatment avenue for patients suffering from refractory BPPV and disabling tinnitus.
• Further research is warranted to evaluate the long-term efficacy and safety of this dual intervention.
• Understanding the interaction between CI and SCC plugging is crucial for optimizing patient outcomes.