Surgical treatment of vertigo

The surgical treatment for vertigo can be accomplished by a number of operations to selectively attack specific areas of the ear or to try to accomplish certain definite changes in the ear. These are called ablation of the posterior semi-circular canal, endolymphatic subarachnoid shunt, middle fossa vestibular nerve section and destructive labyrinthectomy by the transcanal or post-auricular approach, or translabyrinthine section of the VIIIth nerve. In addition, carotid endarterectomy or section of the dorsal spinal rootlets may be indicated for conditions not directly related to the VIIIth nerve or the inner ear. Once a careful diagnosis has been made, the treatment must be adapted to each individual patient's need. No absolute criteria can be used for every patient who has benign disease. When an acoustic neuroma has been detected, it should be removed. With accurate diagnosis and the judicious employment of medical treatment and surgical procedures, physicians can give relief to the majority of their patients who complain of vertigo. A description of the surgical procedures is given. The indications for each operation and the results expected are summarized.