The 20 patients with recurrence required additional gentamicin injections, plus vestibular neurectomy in 2 of them and transmastoid labyrinthectomy for persistent vertigo attacks in 1.
Intratympanic gentamicin injections, in our experience, have nearly eliminated the need for vestibular neurectomy and labyrinthectomy.
In another more reliable operation, a vestibular neurectomy
, the vestibular nerve which serves balance is severed so that it no longer sends distorted messages to the brain.
Selective vestibular neurectomy
is a procedure in which the balance nerve is cut as it leaves the inner ear and goes to the brain.
The success of posterior approaches to both vestibular neurectomy
and hearing-preservation acoustic neuroma surgery has decreased the frequency with which middle fossa procedures are performed for these indications.
For that matter, I am not aware of a single "neurotologist" in the United States whose career is solely dedicated to diagnosis and surgical treatment of intracranial diseases (acoustic tumors, vestibular neurectomy
Human ocular torsional position before and after unilateral vestibular neurectomy
In 1992, we published a survey of 58 head and neck surgeons regarding their use of vestibular neurectomy
, which at that time was gaining popularity as a surgical treatment for Meniere's disease.
4) Surgery is reserved for patients who still do not respond; surgical procedures include endolymphatic sac decompression, vestibular neurectomy
, or labyrinthectomy.
We have performed a combined procedure that involves a vestibular neurectomy
to control vertigo, which is followed by an endolymphatic sac shunt to control hydrops in 26 patients.
Effects of contralateral acoustic stimulation on otoacoustic emissions following vestibular neurectomy
13] If the vertigo attacks continue, the physician can perform either a posterior fossa vestibular neurectomy
or a labyrinthectomy, depending on the level of hearing.