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Vestibular neurectomy vs. chemical labyrinthectomy in the treatment of disabling Menière's disease: a long-term comparative study.

TitleVestibular neurectomy vs. chemical labyrinthectomy in the treatment of disabling Menière's disease: a long-term comparative study.
Publication TypeJournal Article
Year of Publication2009
AuthorsSchmerber S, Dumas G, Morel N, Chahine K, Karkas A
JournalAuris Nasus Larynx
Volume36
Issue4
Pagination400-5
Date Published2009 Aug
ISSN1879-1476
KeywordsAdult, Aged, Audiometry, Pure-Tone, Caloric Tests, Differential Threshold, Disabled Persons, Ear, Inner, Female, Hearing, Humans, Longitudinal Studies, Male, Meniere Disease, Middle Aged, Otologic Surgical Procedures, Recurrence, Reflex, Abnormal, Retrospective Studies, Treatment Outcome, Vestibular Nerve, Young Adult
Abstract

<p><b>OBJECTIVE: </b>To compare the efficiency of vestibular neurectomy (VN) and chemical labyrinthectomy (CL) in the treatment of Menière's disease's disabling vertigo, and to assess their subsequent effects on hearing.</p><p><b>METHODS: </b>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.</p><p><b>RESULTS: </b>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.</p><p><b>CONCLUSION: </b>Vestibular neurectomy and chemical labyrinthectomy offer similar control of vertigo in patients with Menière's disease. CL is a simple, minimally invasive procedure that emerges as an effective method for treating Menière's disabling vertigo without causing significant hearing deterioration.</p>

DOI10.1016/j.anl.2008.08.001
Alternate JournalAuris Nasus Larynx
Citation KeyCK48
PubMed ID19026499