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Transcanal labyrinthectomy for intractable vertigo

P E Hammerschlag, H F Schuknecht

    Archives of Otolaryngology (Chicago, Ill. : 1960)
    |March 1, 1981
    PubMed
    Summary
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    Transcanal labyrinthectomy effectively treats disabling vertigo from unilateral vestibular disease. Most patients achieve relief, with residual unsteadiness being a normal consequence of vestibular loss.

    Area of Science:

    • Otolaryngology
    • Neurosurgery
    • Vestibular System Disorders

    Background:

    • Intractable vertigo from unilateral vestibular disease often requires surgical intervention.
    • Labyrinthectomy offers a definitive treatment option for disabling vertigo.
    • The transcanal approach provides direct access to the vestibular labyrinth.

    Purpose of the Study:

    • To evaluate the efficacy of transcanal labyrinthectomy for intractable vertigo.
    • To assess the outcomes in patients with unilateral Meniere's disease undergoing the procedure.
    • To differentiate between disease persistence and physiological consequences post-surgery.

    Main Methods:

    • Transcanal labyrinthectomy via the oval window was performed on 124 patients.
    • The surgical technique involved visual identification and removal of the utricle, followed by probing of the ampullae.

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  • Ninety patients had unilateral Meniere's disease; four cases of persistent vertigo underwent revision surgery.

    • Main Results:

    • The procedure was effective for most patients with disabling vertigo.
    • Revision surgery successfully managed three out of four cases with moderate-to-severe postoperative vertigo.
    • Twenty-two percent of patients experienced mild, transient unsteadiness with head movements post-surgery.

    Conclusions:

    • Transcanal labyrinthectomy is a viable treatment for disabling unilateral vestibular vertigo.
    • Postoperative unsteadiness is often a physiological result of vestibular nerve ablation, not persistent disease.
    • Revision labyrinthectomy can effectively manage persistent vertigo after the initial procedure.