Selective vestibular neurectomy: a comparison of techniques

The surgical treatment of patients suffering from incapacitating peripheral vertigo is still controversial. In the ENT Department of the Civil Hospital of Venice 43 patients with disabling menieric vertigo spells underwent a selective vestibular nerve section employing either a retrosigmoid (25 cases) or a retrolabyrinthine approach (18 cases) between 1991 and 1993. The two approaches are compared with regard to surgical technique, pre- and postoperative complications and i.e. functional results, i.e. vertigo control and hearing preservation. Functional results, classified according to the guidelines reported by the Committee on Hearing and Equilibrium of the AAO-HNS in 1985 did not show substantial differences. We obtained complete vertigo control in 95% of the patients and hearing was conserved at the preoperative level in almost all of the cases. The retrosigmoid approach demonstrated distinct advantages with regard to the surgical technique employed; it was faster, offered a wider surgical field in the cerebello-pontine angle and brought about fewer peri- and postoperative complications.