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This woman suffered from severe unrelenting migraine headaches and episodic hemiplegic migraine. She was found to have otic capsule dehiscence syndrome, with all clinical features consistent with superior semicircular canal dehiscence, but with a normal CT scan. After failing medical management to try and prevent the migraines from occurring she underwent a left round window reinforcement procedure. Although she did well initially, she developed acute appendicitis with vomiting postoperatively and had recurrence of her symptoms. She had revision round window reinforcement and as documented in this video, she has continued to do well 2 years and 5 months after her surgery.