[Multifrequency vestibular study after vestibular neurotomy and chemical labyrinthectomy]

Vestibular neurotomy (VN) and chemical labyrinthectomy (CL) are the two most common techniques of vestibular deafferention to treat patients with intractable vertigo. A long-term evaluation of vestibular function has been performed with a variety of vestibular tests to find out whether there persisted any residual vestibular function after each technique.

We called in all patients who have been treated for the last 10 years and have no known vestibular disease in the non treated ear. Low frequencies were analyzed with caloric tests, medium frequencies with the head-shaking test and head-impulse test, and high frequencies with the skull vibration test. The otolithic function was explored with the subjective vertical visual analysis and otolithic myogenic evoked potentials. Nine patients treated with VN and 12 with CL presented to our department. We were thus able to compare VN and CL patients with a group of 10 normal patients and another group of nine patients that had had a translabyrinthine approach for an acoustic neuroma.

We found out that vestibular responses did persist in seven out of nine (78 %) patients after VN and 11 out of 12 (92 %) patients after CL. On the other hand, no vestibular response was detected following resection of vestibular schwannoma through a translabyrinthine approach.

We came to the conclusion that the two latter techniques, unlike vestibulocochlear nerve section via the translabyrinthine approach, are only incomplete methods of vestibular deafferention.