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Vestibular nerve section and saccus decompression: An evaluation of long-term results

Published online by Cambridge University Press:  29 June 2007

W. J. Primrose ,
G. D. L. Smyth ,
A. G. Kerr  and
D. S. Gordon
W. J. Primrose*
Affiliation:
Belfast
G. D. L. Smyth
Affiliation:
Belfast
A. G. Kerr
Affiliation:
Belfast
D. S. Gordon
Affiliation:
Consultant Neurosurgeon, Royal Victoria Hospital, Belfast.
*
William J. Primrose, F.R.C.S., Senior Registrar in Otolaryngology, Department of Otorhinolaryngology, Eye and Ear Clinic, Royal Victoria Hospital, Belfast BT12 6BA, Northern Ireland.
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Abstract

The 1972 AAOO committee (Alford, 1972) guidelines brought some uniformity into the evaluation of therapy for Meniere's Disease. We have adhered to its recommendations in this long-term follow-up report of 21 saccus decompressions and 29 vestibular nerve sections performed on 46 patients between 1968 and 1977. Comparisons between these and other groups have been possible with regard to: 1. control of vertigo; 2. hearing; 3. tinnitus; and 4. development of hydrops in the contralateral ear. All the vestibular nerve section group have enjoyed sustained relief from vertigo. Class D results (recurrent vertigo) account for 14 per cent of the saccus decompression group at one year and 29 per cent at eight to 10-year follow-up. Hearing levels in both groups deteriorated in parallel as time progressed but tinnitus became less noticeable. Nineteen per cent of the long-term review patients showed evidence of developing cochlear hydrops in the contralateral ear. Conservative surgical procedures should be employed whilst any useful hearing exists, though the emphasis remains on controlling vertigo. Saccus decompression, despite its controversial therapeutic basis, will remain the first-line surgical procedure for many otologists. However, in the fit young Meniere's cripple or saccus decompression failure with serviceable hearing, vestibular nerve section remains the treatment of choice.

Type
Research Article
Information
The Journal of Laryngology & Otology , Volume 100 , Issue 7 , July 1986 , pp. 775 - 784
Copyright
Copyright © JLO (1984) Limited 1986

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