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Labyrinthectomy versus vestibular neurectomy: long-term physiologic and clinical outcomes.

TitleLabyrinthectomy versus vestibular neurectomy: long-term physiologic and clinical outcomes.
Publication TypeJournal Article
Year of Publication2001
AuthorsEisenman DJ, Speers R, Telian SA
JournalOtol Neurotol
Volume22
Issue4
Pagination539-48
Date Published2001 Jul
ISSN1531-7129
KeywordsAuditory Threshold, Ear, Inner, Electronystagmography, Female, Follow-Up Studies, Hearing Loss, Sensorineural, Humans, Male, Middle Aged, Nystagmus, Pathologic, Otologic Surgical Procedures, Posture, Prospective Studies, Reflex, Vestibulo-Ocular, Severity of Illness Index, Treatment Outcome, Vertigo, Vestibular Nerve, Vestibule, Labyrinth
Abstract

<p><b>OBJECTIVE: </b>To determine whether long-term vestibular compensation (VC) and clinical outcomes differ after transmastoid labyrinthectomy (TML) versus retrolabyrinthine vestibular neurectomy (RVNS).</p><p><b>STUDY DESIGN: </b>Prospective, observational study.</p><p><b>SETTING: </b>Tertiary care, university hospital.</p><p><b>PATIENTS: </b>Twenty-one subjects were studied several years after they were relieved of spontaneous episodic vertigo caused by peripheral vestibular disease by TML or RVNS.</p><p><b>INTERVENTIONS: </b>All patients had undergone TML or RVNS more than 2.5 years before the study and returned for physiologic and functional studies of vestibular compensation.</p><p><b>MAIN OUTCOME MEASURES: </b>Completeness of physiologic VC, as assessed by electronystagmography and rotational chair testing; performance on computerized dynamic posturography; pure-tone and speech audiometry; self-assessment of balance and hearing function with validated survey instruments.</p><p><b>RESULTS: </b>There were no differences in the incidence of physiologic VC or functional recovery between the TML and RVNS subjects. Although a majority of subjects in each group had evidence of incomplete vestibular compensation, there was no difference in self-assessment of balance or hearing handicap at long-term follow-up.</p><p><b>CONCLUSIONS: </b>Long-term clinical balance and hearing outcomes are equivalent when TML and RVNS successfully cure spontaneous, episodic vertigo. There is a high incidence of incomplete VC after both procedures, though this does not usually produce a significant balance handicap.</p>

Alternate JournalOtol. Neurotol.
Citation KeyCK59
PubMed ID11449114