Partial or Total Eighth Nerve Section in the Treatment of Vertigo

Abstract

Partial vestibular (singular) neurectomy under general anesthesia through a postauricular approach is an effective method of relieving incapacitating benign positional vertigo, as is the case in 14 of 16 patients (87%) so treated. Middle fossa vestibular neurectomy appears to be a worthwhile procedure to deinnervate the peripheral vestibular system while preserving hearing. The results of 27 middle fossa vestibular neurectomies indicate relief of vertigo in 85% of the patients. The results of treatment on 44 patients undergoing transmeatal-cochleovestibular neurectomy indicated that vertigo was relieved in 19 of 23 (82%) with Meniere's disease and Improved in 50% of the patients with poststapedectomy vertigo and sensorineural hearing loss. Tinnitus was cured or markedly improved in 80% of the patients with Meniere's disease and 70% of the patients with poststapedectomy sensorineural hearing loss and tinnitus. The transmeatal-transcochlear approach to the internal auditory canal offers advantages over the transmeatal labyrinthectomy or translabyrinthine approach to the internal auditory canal.