Posterior fossa vestibular neurectomy

AbstractMany procedures have been devised to deal with intractable vertigo and conserve hearing, but despite this selective vestibular nerve section remains by far the most effective treatment.A series of 14 patients who underwent posterior fossa vestibular neurectomy is reported. The results are reported for vertigo control, hearing and tinnitus. All of the patients achieved vertigo control according to the AAOO (1972) reporting system. A simple and reliable system for the classification of the disability in these patients has yet to be devised. This problem is addressed and a disability grading system proposed, and discussed.

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Posterior Fossa Vestibular Nerve Section with Simultaneous Decompression of the Endolymphatic Sac: A Preliminary Report

Skull Base Surgery ◽

10.1159/000430015 ◽

2015 ◽

pp. 960-961

Author(s):

Afaged El Shennawy

Keyword(s):

Posterior Fossa ◽

Preliminary Report ◽

Vestibular Nerve ◽

Endolymphatic Sac ◽

Nerve Section

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Vestibular nerve section following previous mastoidectomy

The Journal of Laryngology & Otology ◽

10.1017/s002221510013511x ◽

1996 ◽

Vol 110 (9) ◽

pp. 836-840

Author(s):

Abhi A. Parikh ◽

Gerald B. Brookes

Keyword(s):

Otitis Media ◽

Chronic Otitis Media ◽

Senior Author ◽

Vestibular Nerve ◽

Mastoid Cavity ◽

Previous Surgery ◽

Nerve Section ◽

Suppurative Otitis Media ◽

Vestibular Neurectomy ◽

Selection Of

AbstractVestibular neurectomy is an effective procedure in the management of vertigo due to active labyrinthine disease. Various approaches have been developed for selectively sectioning the vestibular nerve, in order to preserve serviceable hearing and avoid facial nerve injury.In patients who have a mastoid cavity, from previous surgery for chronic otitis media, the approach to the vestibular nerve has to be modified. Considerations taken into account are cavity infection, hearing status, and the presence of associated loud tinnitus.Vestibular or vestibulo-cochlear nerve section has been undertaken, by the senior author, in eight patients with a mastoid cavity from previous surgery for chronic otitis media. Translabyrinthine, retrosigmoid and middle fossa approaches have all been used; strategies for selection of each specific technique are considered, and the aetiology of post-chronic suppurative otitis media (CSOM) peripheral vestibular disease discussed.

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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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Analysis of Patients with Persistent Dizziness after Vestibular Nerve Section

Ear Nose & Throat Journal ◽

10.1177/014556139807700411 ◽

1998 ◽

Vol 77 (4) ◽

pp. 290-298 ◽

Cited By ~ 12

Author(s):

Bradley S. Thedinger ◽

Britt A. Thedinger

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Vestibular Nerve ◽

Surgical Approaches ◽

Central Nervous System Diseases ◽

Nerve Section ◽

Vestibular Neurectomy ◽

Advantages And Disadvantages ◽

Effective Operation ◽

System Compensation

Vestibular neurectomy can be an effective operation for the control of persistent dizziness refractory to medical treatment or even endolymphatic sac surgery. Past studies have reported favorable results, creating an almost deceptive impression of the procedure's success rate. However, not all patients will respond favorably. Some will continue to have significant postoperative disequilibrium and, worse yet, persistent vertigo. To analyze the reasons for continued problems, 142 patients undergoing various surgical approaches employed to divide the vestibular nerve (retrolabyrinthine, middle fossa, retrosigmoid and translabyrinthine) were retrospectively reviewed. Twenty-nine patients (20%) continued to have significant dizziness despite vestibular neurectomy. The reasons for failure were incomplete vestibular nerve section, poor central nervous system compensation, new vestibular disease in the opposite ear, obstructive anatomy, the presence of other central nervous system diseases, and unknown causes. This paper will detail the advantages and disadvantages of various vestibular neurectomy approaches and will present recommendations for further treatment of this difficult-to-manage group of patients.

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Posterior fossa vestibular nerve section for the management of peripheral vertigo

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s004050050147 ◽

1999 ◽

Vol 256 (5) ◽

pp. 230-232 ◽

Cited By ~ 4

Author(s):

L. Beder ◽

N. G�ksu ◽

Y. Bayaz?t

Keyword(s):

Posterior Fossa ◽

Vestibular Nerve ◽

Nerve Section ◽

Peripheral Vertigo

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Retrolabyrinthine Vestibular Nerve Section: A Current Appraisal

Ear Nose & Throat Journal ◽

10.1177/014556139707600816 ◽

1997 ◽

Vol 76 (8) ◽

pp. 578-583 ◽

Cited By ~ 7

Author(s):

Miguel Aristegui ◽

Yasar Cokkeser ◽

Rinaldo F. Canalis ◽

Fernando Mancini ◽

Mario Sanna ◽

...

Keyword(s):

Success Rate ◽

Current Literature ◽

Vestibular Nerve ◽

Nerve Section ◽

Vestibular Neurectomy ◽

Anatomical Features ◽

Successful Technique ◽

Continued Use ◽

Retrolabyrinthine Approach ◽

A Current

We report our experience (1987-1993) with Meniere's disease patients treated with a retrolabyrinthine vestibular neurectomy. The current literature was reviewed and our results have been compared with those of previous reports. The overall success rate for vertigo relief was 96.7%, with no serious or permanent complications resulting from the procedure. The technical elements of the operation, as they apply to our approach and those of others, have been analyzed, with special attention given to the anatomical features of the region and their influence on success or failure. We conclude that the retrolabyrinthine approach for vestibular nerve section remains a safe and highly successful technique which merits continued use.

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New Design for a Differentially Pumped Hydration Chamber for a Siemens IA

Proceedings, annual meeting, Electron Microscopy Society of America ◽

10.1017/s042482010006427x ◽

1971 ◽

Vol 29 ◽

pp. 44-45

Author(s):

R. C. Moretz ◽

G. G. Hausner ◽

D. F. Parsons

Keyword(s):

Electron Microscopy ◽

Water Vapor ◽

Electron Diffraction ◽

Water Vapor Pressure ◽

Biological Materials ◽

Thin Membrane ◽

Reliable System ◽

System A ◽

Water Films ◽

Aperture Opening

Electron microscopy and diffraction of biological materials in the hydrated state requires the construction of a chamber in which the water vapor pressure can be maintained at saturation for a given specimen temperature, while minimally affecting the normal vacuum of the remainder of the microscope column. Initial studies with chambers closed by thin membrane windows showed that at the film thicknesses required for electron diffraction at 100 KV the window failure rate was too high to give a reliable system. A single stage, differentially pumped specimen hydration chamber was constructed, consisting of two apertures (70-100μ), which eliminated the necessity of thin membrane windows. This system was used to obtain electron diffraction and electron microscopy of water droplets and thin water films. However, a period of dehydration occurred during initial pumping of the microscope column. Although rehydration occurred within five minutes, biological materials were irreversibly damaged. Another limitation of this system was that the specimen grid was clamped between the apertures, thus limiting the yield of view to the aperture opening.

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