Long-term deficits in otolith, canal and optokinetic ocular reflexes of pigmented rats after unilateral vestibular nerve section

AbstractObjective:To present the profile of patients undergoing surgical treatment for vertigo at a contemporary institutional vertigo clinic.Study design:A retrospective analysis of clinical charts.Methods:The charts of 1060 patients, referred to an institutional vertigo clinic from January 2003 to December 2012, were studied. The clinical profile and long-term outcomes of patients who underwent surgery were analysed.Results:Of 1060 patients, 12 (1.13 per cent) were managed surgically. Of these, disease-modifying surgical procedures included perilymphatic fistula repair (n = 7) and microvascular decompression of the vestibular nerve (n = 1). Labyrinth destructive procedures included transmastoid labyrinthectomy (n = 2) and labyrinthectomy with vestibular nerve section (n = 1). One patient with vestibular schwannoma underwent both a disease-modifying and destructive procedure (translabyrinthine excision). All patients achieved excellent vertigo control, classified as per the American Academy of Otolaryngology – Head and Neck Surgery 1995 criteria.Conclusion:With the advent of intratympanic treatments, surgical treatments for vertigo have become further limited. However, surgery with directed intent, in select patients, can give excellent results.

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Vestibular Nerve Section: Long-term Follow-up

The Laryngoscope ◽

10.1097/00005537-199709000-00009 ◽

1997 ◽

Vol 107 (9) ◽

pp. 1203-1209 ◽

Cited By ~ 32

Author(s):

Dennis G. Pappas ◽

Dennis G. Pappas

Keyword(s):

Vestibular Nerve ◽

Nerve Section ◽

Long Term Follow Up

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Labyrinthectomy and Vestibular Neurectomy for Intractable Vertiginous Symptoms

International Archives of Otorhinolaryngology ◽

10.1055/s-0037-1599242 ◽

2017 ◽

Vol 21 (02) ◽

pp. 184-190 ◽

Cited By ~ 6

Author(s):

Alfredo Alarcón ◽

Lourdes Hidalgo ◽

Rodrigo Arévalo ◽

Marite Diaz

Keyword(s):

Vestibular Function ◽

Hearing Preservation ◽

Vestibular Nerve ◽

Complication Rates ◽

Surgical Morbidity ◽

Nerve Section ◽

Vestibular Neurectomy ◽

Intracranial Complications ◽

Chemical Labyrinthectomy

Introduction Labyrinthectomy and vestibular neurectomy are considered the surgical procedures with the highest possibility of controlling medically untreatable incapacitating vertigo. Ironically, after 100 years of the introduction of both transmastoid labyrinthectomy and vestibular neurectomy, the choice of which procedure to use rests primarily on the evaluation of the hearing and of the surgical morbidity. Objective To review surgical labyrinthectomy and vestibular neurectomy for the treatment of incapacitating vestibular disorders. Data Sources PubMed, MD consult and Ovid-SP databases. Data Synthesis In this review we describe and compare surgical labyrinthectomy and vestibular neurectomy. A contrast between surgical and chemical labyrinthectomy is also examined. Proper candidate selection, success in vertigo control and complication rates are discussed on the basis of a literature review. Conclusions Vestibular nerve section and labyrinthectomy achieve high and comparable rates of vertigo control. Even though vestibular neurectomy is considered a hearing sparing surgery, since it is an intradural procedure, it carries a greater risk of complications than transmastoid labyrinthectomy. Furthermore, since many patients whose hearing is preserved with vestibular nerve section may ultimately lose that hearing, the long-term value of hearing preservation is not well established. Although the combination of both procedures, in the form of a translabyrinthine vestibular nerve section, is the most certain way to ablate vestibular function for patients with no useful hearing and disabling vertigo, some advocate for transmastoid labyrinthectomy alone, considering that avoiding opening the subarachnoid space minimizes the possible intracranial complications. Chemical labyrinthectomy may be considered a safer alternative, but the risks of hearing loss when hearing preservation is desired are also high.

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Long-term Hearing Results Following Middle Fossa Vestibular Nerve Section

Archives of Otolaryngology - Head and Neck Surgery ◽

10.1001/archotol.1989.01860260015005 ◽

1989 ◽

Vol 115 (2) ◽

pp. 141-141

Author(s):

H. C. PILLSBURY

Keyword(s):

Vestibular Nerve ◽

Middle Fossa ◽

Nerve Section ◽

Hearing Results

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Vestibular nerve section and saccus decompression: An evaluation of long-term results

The Journal of Laryngology & Otology ◽

10.1017/s0022215100100076 ◽

1986 ◽

Vol 100 (7) ◽

pp. 775-784 ◽

Cited By ~ 8

Author(s):

W. J. Primrose ◽

G. D. L. Smyth ◽

A. G. Kerr ◽

D. S. Gordon

Keyword(s):

Vestibular Nerve ◽

Long Term Results ◽

First Line ◽

Nerve Section ◽

Class D ◽

Long Term Follow Up ◽

Contralateral Ear ◽

One Year

AbstractThe 1972 AAOO committee (Alford, 1972) guidelines brought some uniformity into the evaluation of therapy for Meniere's Disease. We have adhered to its recommendations in this long-term follow-up report of 21 saccus decompressions and 29 vestibular nerve sections performed on 46 patients between 1968 and 1977. Comparisons between these and other groups have been possible with regard to: 1. control of vertigo; 2. hearing; 3. tinnitus; and 4. development of hydrops in the contralateral ear. All the vestibular nerve section group have enjoyed sustained relief from vertigo. Class D results (recurrent vertigo) account for 14 per cent of the saccus decompression group at one year and 29 per cent at eight to 10-year follow-up. Hearing levels in both groups deteriorated in parallel as time progressed but tinnitus became less noticeable. Nineteen per cent of the long-term review patients showed evidence of developing cochlear hydrops in the contralateral ear. Conservative surgical procedures should be employed whilst any useful hearing exists, though the emphasis remains on controlling vertigo. Saccus decompression, despite its controversial therapeutic basis, will remain the first-line surgical procedure for many otologists. However, in the fit young Meniere's cripple or saccus decompression failure with serviceable hearing, vestibular nerve section remains the treatment of choice.

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Long-Term Hearing Results following Middle Fossa Vestibular Nerve Section

Otolaryngology ◽

10.1177/019459988910000106 ◽

1989 ◽

Vol 100 (1) ◽

pp. 35-40 ◽

Cited By ~ 10

Author(s):

Michael E. Glasscock ◽

Glenn D. Johnson ◽

Dennis S. Poe

Keyword(s):

Meniere’S Disease ◽

Vestibular Nerve ◽

Meniere's Disease ◽

Ménière’S Disease ◽

Middle Fossa ◽

Menière's Disease ◽

Nerve Section ◽

Ménière's Disease

Hearing stabilization following middle fossa vestibular nerve section (MFVNS) has been observed to occur in a large percentage of patients (71% to 86%) after short-term followup. This study looks at the long-term audiological followup (5 to 15 years) of 46 patients who underwent a MFVNS for intractable Meniere's disease. Although the percentage of patients with stabilized hearing was relatively high within the first 2 years postoperatively (61%), it dropped to 41% after a longer followup of 5 to 15 years. When this patient population is divided into two groups based on their preoperative PTA, those patients in whom hearing had bottomed out to ≥50 dB PTA preoperatively lost only 5 dB PTA over the course of the follow-up period. The patients with better preoperative hearing (<50 dB PTA) lost 30 dB PTA over the same follow-up period. As this pattern is similar to what has been observed in nonsurgically treated Meniere's patients, we conclude that the MFVNS has no beneficial effect on the hearing loss associated with Meniere's disease.

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Long-term results of vestibular nerve section

The Journal of Laryngology & Otology ◽

10.1017/s0022215100142719 ◽

1998 ◽

Vol 112 (12) ◽

pp. 1150-1153 ◽

Cited By ~ 17

Author(s):

A. K. Tewary ◽

N. Riley ◽

A. G. Kerr

Keyword(s):

Vestibular Nerve ◽

Long Term Results ◽

Partial Recovery ◽

Nerve Section ◽

Profound Hearing Loss ◽

Episodic Vertigo ◽

Average Improvement ◽

Long Term Follow Up

AbstractRecords are available on 27 patients who had vestibular nerve section between 1975 and 1987 giving a follow-up time of 10 to 22 years with a mean of 16 years. Episodic vertigo was fully controlled in 26 patients, one needing a labyrinthectomy 18 months later.In addition to the patient who had labyrinthectomy, one patient had immediate post-operative profound hearing loss so that long-term follow-up of hearing was possible in 25 patients. After six months there was an overall average improvement in hearing of 1 dB. Thereafter there were average deterioration of 7 dB at two years, 15 dB at 10 years, 23 dB at 15 years and 29 dB at 20 years. This deterioration was more marked in those who had better hearing at the time of surgery, with all 10 whose hearing was classified as good deteriorating to poor by 15 years. At 10 years hearing deteriorated by 25 dB in those with good hearing and by 7 dB in those with poor hearing. In 20 per cent of patients there was audiological evidence of eventual involvement of the other ear.Tinnitus became worse in five patients but was a major problem in only one patient. One patient suffered a facial paralysis with partial recovery and, in addition, in one the frontal branch was divided in the incision.

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