Lateral Semicircular Canal Occlusion in Patients with Refractory Meniere's Disease

Meniere's disease remains a controversial condition not only in terms of its etiology and diagnosis but also its treatment. Approximately 2%-5% of patients do not improve or reach the control of their vestibular symptoms with any pharmacological therapy. Surgery of lateral semicircular canal (LSCC) occlusion could be an alternative to control the symptoms.

Twenty consecutive patients with clinical and oto-neurological diagnosis of Meniere's disease were included. Twelve women and 8 men with a mean age of 51 years (range, 29-72) were studied. All affected with unilateral or at least marked unilateral asymmetry in audio-gram. All patients who underwent surgery received general anesthesia. Canal wall up mastoidectomy was performed. After the LSCC was identified, a bony surface of the semicircular canal was drilled using a 1 mm diamond burr until the membranous labyrinth was discovered (blue line). The canal was then blocked with a mixture of bone wax and bone dust in an area of 2 or 3 mm, at the most prominent part of the semicircular canal.

All patients in the study had an average hospital stay of 36 hours, of which 10 required additional medication (ondansetron). All were given 75 mg of cinnarizine orally once daily for 10 days. After that, only 4 patients continued taking betahistine for 1 month. One month later, no patients were taking medication for vertigo.

Lateral semicircular canal occlusion seems to be an effective surgical option for patients with refractory Meniere's disease.