Assessment of auditory and vestibular functions after vestibular neurectomy for Menière's disease.

Abstract

Fourteen patients (12 Meniere's disease, one delayed endolymphatic hydrops and one labyrinthitis) suffering from intractable vertigo were treated with retrosigmoid vestibular neurectomy (RSVN) in our institute. Dizziness was controlled completely in all patients. Hearing was preserved in 91.7% of the cases with pure tone threshold deteriorating by more than 10 dB in one case, remained unchanged in 10 cases and improved in one case during long term observation. Substantial decrease of tinnitus was observed in 78.6%. Vestibular compensation was chronologically analyzed with a stabilometer, ENG and vestibular rotation test (0.01-0.64 Hz). Vestibular compensation under static conditions was accomplished within 2 weeks, except for spontaneous nystagmus measured in the dark. Asymmetry of vestibulo-ocular reflex was noted 2 weeks after the operation but had disappeared after 4 weeks. However, for over 2 years the VOR time constant remained lower (4.3-5.2 s) than the pre-operative value (8.2 s). Electro-cochleogram (ECoG) was recorded before and after RSVN. The -SP/AP ratio tended to increase after RSVN in the operated ear, though there was no change in the contralateral ear. The efferent olivo-cochlear bundle was thought to play a potential role in this increase of the -SP/AP ratio.