Vestibular neurectomy: a histological and clinical study of results

Posterior fossa vestibular neurectomy has become one of the most effective surgical procedures for control of vertigo symptoms in Menière's disease. A small group of patients continue to have vertigo and demonstrable vestibular function by electronystagmography (ENG) post-operatively. Another group of patients may have no vertigo, despite residual vestibular function on caloric testing. In an effort to correlate histological findings with clinical outcome, nerve biopsies were taken from seven patients undergoing vestibular neurectomy. Fibre counts of nerve biopsies were compared with clinical, audiometric and ENG results. Results of this study demonstrate that complete reduction of vestibular response (on caloric testing) and clinical cure of vertigo can be obtained despite a variable number of nerve fibres at vestibular neurectomy.