[Surgical treatment of vestibular vertigo: methods and indications]

After the failure of medical treatment of dizziness or vertigo, surgical treatment is chosen according to functional diagnosis and duration and severity of symptoms. Surgery is contraindicated in patients with incomplete vestibular compensation, central nervous disorders and bilateral vestibular deficits. Surgery is obligatory in cases of sudden loss of labyrinthine function with traumatic perilymph fistula, middle ear and temporal bone processes. Endolymphatic hydrops and pathological endolymph pressure of other etiology as impaired middle ear ventilation, EVAS or superior semicircular canal dehiscence can be treated surgically. Resurfacing of dehiscence with glas ceramic implants is presented. Occlusion of the posterior semicircular canal is restricted to extremely rare conditions with non-responders to repositioning maneuvers. Ablative procedures, such as cochleosacculotomy and vestibular neurectomy are rarely indicated. More than 85% of non-responders to conservative treatment procedures in vestibular dysfunction can be improved by means of surgical procedures. Otologists have access to procedures for differentiation, indications and therapy via the network of general practitioners and hospital physicians.