Use of TissuePatchDural (TM) in the closure of an iatrogenic fistula following posterior semicircular canal occlusion surgery for intractable benign paroxysmal positional vertigo

Benign paroxysmal positional vertigo (BPPV) is a common disorder caused by the dislocation of otoconia most commonly into the posterior canal. The primary symptoms are brief episodes of head-position related vertigo which may be accompanied by nausea and disequilibrium. BPPV is usually managed conservatively with excellent results, however in a small number of cases the symptoms can become persistent and incapacitating. The most common treatment in such cases involves the surgical occlusion of the canal. This procedure carries a small risk of post operative perilymph leakage via an iatrogenic fistula. In this paper we outline a case of a patient who developed a perilymph leak following occlusion surgery for intractable BPPV. We describe a novel surgical method that was used to close the fistula using a synthetic polymer based patch (TissuePatchDural T), which has not been applied in the field of otology previously.