Transcanal endoscopic horizontal semicircular canal occlusion for Meniere's disease: A case series of 4 patients.

RATIONALE: Semicircular canal occlusion (SCO) is used to treat vestibular vertigo with demonstrated efficacy. This study introduces a novel transcanal endoscopic approach for horizontal SCO to manage vertigo in refractory Meniere's disease (MD).

PATIENT CONCERNS: Four patients with refractory MD, previously managed conservatively for over 6 months, presented with severe-to-profound hearing loss. Their vertigo symptoms progressively worsened and severely compromised quality of life.

DIAGNOSES: All 4 patients met diagnostic criteria for definite MD with severe-to-profound hearing loss.

INTERVENTIONS: All patients underwent transcanal endoscopic horizontal SCO with a 12-month postoperative follow-up to evaluate clinical outcomes and procedural safety.

OUTCOMES: Postoperative vertigo control was effective, demonstrating significant reductions in both attack frequency and symptom intensity. Subjective tinnitus improved in 1 patient and remained stable in the remaining 3. Hearing thresholds were preserved in all cases without progression. Transient postoperative disequilibrium occurred in 1 patient, resolving spontaneously without complications.

LESSONS: Transcanal endoscopic horizontal SCO represents a safe, effective, and clinically viable alternative to pharmacologic conservative management for refractory MD with severe-to-profound hearing loss persisting beyond 6 months.