Labyrinthectomy and Vestibular Neurectomy for Intractable Vertiginous Symptoms.

Area of Science:

• Otolaryngology
• Neurosurgery
• Vestibular Disorders

Background:

• Incapacitating vertigo often requires surgical intervention when medical treatments fail.
• Labyrinthectomy and vestibular neurectomy are primary surgical options for intractable vertigo.
• Decision-making between these procedures historically hinges on hearing status and surgical risks.

Purpose of the Study:

• To review and compare surgical labyrinthectomy and vestibular neurectomy for treating severe vestibular disorders.
• To evaluate the efficacy and safety profiles of these surgical interventions.
• To contrast surgical approaches with chemical labyrinthectomy.

Main Methods:

• Comprehensive literature review of PubMed, MD Consult, and Ovid-SP databases.
• Analysis of candidate selection, vertigo control success rates, and complication data.
• Comparison of transmastoid labyrinthectomy, vestibular neurectomy, and chemical labyrinthectomy.

Main Results:

• Both vestibular nerve section and labyrinthectomy demonstrate high and comparable vertigo control rates.
• Vestibular neurectomy, an intradural procedure, carries higher complication risks than transmastoid labyrinthectomy.
• Long-term hearing preservation with vestibular nerve section is not consistently established.

Conclusions:

• Vestibular neurectomy and labyrinthectomy are effective for vertigo management, with differing risk profiles.
• Transmastoid labyrinthectomy may be preferred to minimize intracranial complications.
• Chemical labyrinthectomy presents an alternative but carries significant risks of hearing loss.