Retrosigmoid approach for vestibular neurectomy in Meniere's disease

R Perez, A Ducati, D Garbossa, F Benech, M M Fontanella, A Canale, R Albera
Acta Neurochirurgica 2005, 147 (4): 401-4; discussion 404

BACKGROUND: Vestibular nerve section is considered to be the most effective surgical procedure to control intractable symptoms secondary to Meniere's disease (MD). This study was developed to analyze the adequacy of retrosigmoid vestibular neurectomy in terms of vertigo control, hearing preservation and clinical complications of this procedure.

METHODS: A retrospective review was carried out on 14 patients affected by definite unilateral MD who underwent vestibular neurectomy via the retrosigmoid approach.

FINDINGS: One patient was lost from follow-up; another one had only a short postoperative observation. At follow-up performed on 12 cases, no patients reported any crisis of acute vertigo. Four patients were free from any vestibular symptoms, while 8 reported some slight gait disturbances. Hearing function was preserved in 10 patients and improved in 2. 1 year postoperative vestibular function was absent at the side operated on and unchanged on the other side in all the cases.

CONCLUSIONS: Vestibular neurectomy via the retrosigmoid approach can be considered a safe and effective procedure in relieving medically refractory vertigo in Meniere's disease, while preserving hearing.

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