Lateral Semicircular Canal Plugging in Severe Ménière's Disease

Abstract

OBJECTIVE: To evaluate the safety and efficiency of the plugging of the lateral semicircular canal to control vertigo in severe Ménière's disease (MD). STUDY DESIGN: Prospective follow-up study. SETTING: University hospital. PATIENTS: Twenty-eight patients with MD with refractory vertigo and severe disability (functional scale 5 or 6). INTERVENTIONS: Lateral canal plugging was performed in pathological ear for each patient. MAIN OUTCOME MEASURES: The evaluation of therapy followed the guidelines for diagnosis and evaluation of therapy in MD (1995). Hearing, frequency of vertigo, and functional disability were assessed in the early follow-up (6 mo) for all the patients and in the late follow-up (2 yr) for 16 patients. In addition, the canal paresis was evaluated by caloric test. RESULTS: No vital complication occurred. The hearing was preserved in 82% of cases. Lateral canal plugging induced in all cases a canal paresis that was persistent after 2 years. After 2 years (n = 16), the control of vertigo was complete or substantial in 75% of cases (A1, restoration of a normal life: 62.5%; B2, no functional restriction: 12.5%). CONCLUSION: Lateral canal plugging is a safe procedure that induces a canal paresis and allows a good control of vertigo. In view of these results, the lateral canal plugging should be a therapeutic option for controlling rotatory vertigo in severe MD.