Abstract
The combined retrolabyrinthine-retrosigmoid vestibular neurectomy, developed in 1987, represents our current approach for microsurgical posterior fossa vestibular neurectomy. It replaces the retrolabyrinthine vestibular neurectomy, introduced in 1978, and the retrosigmoid-internal auditory canal vestibular neurectomy, developed in 1985. This procedure combines the advantages of both previous techniques. The surgeon has the option of performing the vestibular neurectomy in the cerebellopontine angle if well-defined cleavage plane is present (75% of cases), or more laterally in the internal auditory canal, where the cleavage plane is better defined. Control of vertigo is excellent, with a low rate of complications. This technique represents a further refinement in vestibular neurectomy and has become our procedure of choice for the patient with disabling vertigo and some serviceable hearing.
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