Surgery for non-Menière's vertigo.

Abstract

Neurootologists are fortunate in having a considerable number of surgical options available to them for the treatment of patients with disabling vertigo. Most surgery for vertigo is performed on patients suffering from the ravages of Meniere's disease. In addition, other forms of disabling peripheral vertigo may also be surgically managed. Over a 3 year period, the author performed surgery on 14 patients suffering from disabling non-Meniere's vertigo. During the same period, 60 patients with Meniere's disease underwent surgical treatment. There were three non-Meniere's conditions for which surgery was performed: chronic vestibular neuronitis, delayed onset vertigo (after sensorineural hearing loss), and labyrinthine injury following temporal bone fracture. Two surgical operations were utilized: transmastoid labyrinthectomy and selective vestibular neurectomy. At 1 year follow-up all of the patients involved in this study enjoyed either total relief of symptoms or marked improvement, demonstrating that satisfactory surgical results can be obtained for non-Meniere's vertigo. However, surgeons must exercise extreme caution in selecting non-Meniere's patients for surgery. Moreover, proper patient selection, accurate diagnosis and the exclusion of central disease are crucial in obtaining good surgical results.