NaCl deposition in the vestibule: a simple, safe, and effective method of cochleovestibular deafferentation

Chemical cochleovestibular deafferentation was performed on 21 individuals suffering from disabling vertigo caused by unilateral Menière's disease. Patients ranged in age from 31 to 60 years, with a mean age of 47.4. The duration of the disease spanned 3 to 14 years, mean duration being 5.8 years. Subjects displayed pure-tone thresholds higher than 50 dB HL in the affected ear and better than 25 dB HL in the contralateral ear. The frequency of vertigo, evaluated during the 6 months before surgery, ranged from 1 crisis a month to 2 a week; mean duration of crises was 1 to 6 hours. Medical treatment had failed in all cases. The surgical procedure consisted of stapedectomy, deposition of several crystals of NaCl in the vestibule, and sealing of the oval window with a vein graft. Postoperative recovery was rapid, allowing patients to be discharged 4 to 6 days after surgery. All subjects reported complete relief of vertigo. Tinnitus disappeared in 47.6% of the subjects, was reduced in 33.3% and unchanged in 19.1%. Most patients complaining of aural fullness preoperatively reported relief of this symptom after surgery. The outcomes of the present study indicate that NaCl deposition into the vestibule is a simple, safe, and effective technique of cochleovestibular deafferentation.