Combined retrosigmoid retrolabyrinthine vestibular nerve section: results of our experience over 10 years

Nebil Goksu, Metin Yilmaz, Ismet Bayramoglu, Yildirim A Bayazit
Otology & Neurotology 2005, 26 (3): 481-3

OBJECTIVE: We aimed to evaluate the results of our experience in vestibular nerve sectioning (VN), which was performed using combined retrosigmoid-retrolabyrinthine approach.

STUDY DESIGN: Medical records of 280 patients who were consecutively operated on for incapacitating peripheral vertigo were retrospectively evaluated, and 210 patients who completed 2 years follow-up and had adequate follow-up data were found to be suitable for inclusion in the study.

METHODS: Hearing results, vertigo control rates, and complications of the retrosigmoid-retrolabyrinthine VN were evaluated.

RESULTS: The patients were suffering from vertigo for a mean period of 32.2 months. Bilateral Meniere's disease occurred in 5.7% of the patients in the follow-up period. A complete or substantial vertigo control could be achieved in 94.4% of the patients (191 [90.1%] in Class A and 9 [4.3%] in Class B). Preoperative speech reception threshold, pure-tone average, and speech discrimination score of the patients were 56.5 dB, 47.4 dB, and 73.6%, respectively. Postoperative corresponding values were 62.2 dB, 43.4 dB, and 68.5%, respectively (p > 0.05). The complication rate was low (2.5%). Most common complication was abdominal hematoma, which was seen in 4.5%.

CONCLUSION: VN performed using retrosigmoid-retrolabyrinthine approach has low complication and high vertigo control and hearing preservation rates. It can be applied as an initial surgery or reserved as the last step when the other surgical treatments have failed to control vertigo.

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