Abstract
Surgical treatments of vertigo are reviewed. The operations which sacrifice hearing in Meniere disease, are labyrinthectomy and trans-labyrinthine vestibular neurectomy. The commonest operation is an endolymphatic sac operation, with several variations. Vestibular neurectomies through middle fossa, retro-labyrinthine and retro-sigmoid approaches are the most effective ways to control vertigo, but these operations require neurootological skills and knowledge. We reported our results of retrosigmoid vestibular neurectomy: complete relief of vertigo in all 14 patients ; hearing preserved in 91.7%; tinnitus decreased in 78.6%. Shea described streptomycin perfusion into the lateral semicircular canal as a conservative operation for Meniere disease. In our experience with this operation vertigo was eliminated in 83.3%, and hearing was preserved in only 16.6%. Various sac operations (Fick, Cody, Cochleosacculotomy) are considered to be conservative surgery, but hearing loss is a frequent complication. Operations for other kinds of dizziness mentioned here are singular neurectomy and posterior canal block for benign paroxysmal positional vertigo, decompression operation for vascular compression syndrome, and obliteration operation for perilymphatic fistula.
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