Vestibular neurectomy vs. chemical labyrinthectomy in the treatment of disabling Menière's disease: a long-term comparative study

Sébastien Schmerber, Georges Dumas, Nils Morel, Karim Chahine, Alexandre Karkas
Auris, Nasus, Larynx 2009, 36 (4): 400-5

OBJECTIVE: To compare the efficiency of vestibular neurectomy (VN) and chemical labyrinthectomy (CL) in the treatment of Menière's disease's disabling vertigo, and to assess their subsequent effects on hearing.

METHODS: This is a retrospective study of 58 VN procedures and 35 CL procedures. Treatment results were assessed by caloric testing and pure-tone audiometry performed before and after treatment. Subjective success was defined by the number of recurrent attacks of vertigo and by the AAO-HNS vertigo scale.

RESULTS: Caloric testing revealed strong vestibular hyporeflexia in 91.0% of VN cases and 86.0% of CL cases. Vertigo recurred in 7.0% of cases in the VN group and in 11.4% of cases in the CL group. Mean pure-tone auditory thresholds increased from 45.00dB HL to 50.84dB HL (p=0.19) in the VN group and from 69.11dB HL to 74.51dB HL (p=0.41) in the CL group.

CONCLUSION: Vestibular neurectomy and chemical labyrinthectomy offer similar control of vertigo in patients with Menière's disease. CL is a simple, minimally invasive procedure that emerges as an effective method for treating Menière's disabling vertigo without causing significant hearing deterioration.

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