めまいの外科的治療

Abstract

For the management of patients complaining of vertigo, less-invasive treatments should initially be selected. However, failure of conservative treatment necessitates consideration of more invasive procedures. These managements sometimes include surgical measures, which could be associated with some complications.For benign paroxysmal positional vertigo, canal plugging surgery may be a valid treatment option. In the case of Meniere’s disease, ventilation tube insertion, endolymphatic sac decompression, intratympanic gentamicin injection, vestibular neurectomy and vestibulotomy can be used for critical cases. In cases with superior canal dehiscence, surgical treatment (re-surfacing of middle cranial fossa and anterior semi-circular canal plugging) is the only treatment option that offers the opportunity for resolution of symptoms. Recently, surgery for small tumors of the cerebellopontine cistern have tended to be avoided, although certain cases do need surgery. Devices to compensate for vestibular deficit, some of which need surgical device insertion, are also under research and development. It is necessary for physicians to be aware about the treatment options, including surgical procedures, with their benefits and risks, for appropriate treatment of vertigo. At the same time, we should be cautious about the selection, evaluation and establishment of surgical treatment procedures.