Retrolabyrinthine or retrosigmoid vestibular neurectomy: indications

Selective vestibular nerve section is indicated for the treatment of vertigo in unilateral Meniere's disease or other inner ear disorders, in patients with salvageable hearing. Since 1978, the retrolabyrinthine approach to the vestibular nerve in the cerebellopontine angle has been used extensively with good success and minimal morbidity. In an attempt to obtain more complete section of the vestibular nerve, the retrosigmoid-internal auditory canal approach was developed in 1985 and has been employed in 13 patients, all of whom obtained complete control of vertigo. The surgical techniques are presented with emphasis on the advantages and disadvantages of each approach. Relative indications and contraindications are suggested.