Schmerber, S{'e}bastien ; Dumas, Georges ; Morel, Nils ; Chahine, Karim ; Karkas, Alexandre

Vestibular neurectomy vs. chemical labyrinthectomy in the treatment of disabling Meni`eretextquoterights disease: a long-term comparative study. Journal Article

Auris Nasus Larynx, 36 , pp. 400-5, 2009, ISSN: 1879-1476.

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Abstract

OBJECTIVE: To compare the efficiency of vestibular neurectomy (VN) and chemical labyrinthectomy (CL) in the treatment of Meni`eretextquoterights diseasetextquoterights 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 Meni`eretextquoterights disease. CL is a simple, minimally invasive procedure that emerges as an effective method for treating Meni`eretextquoterights disabling vertigo without causing significant hearing deterioration.