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Vestibular nerve section following previous mastoidectomy

Published online by Cambridge University Press:  29 June 2007

Abhi A. Parikh
Affiliation:
Royal National Throat, Nose and Ear Hospital, London, UK.
Gerald B. Brookes*
Affiliation:
National Hospital for Neurology and Neurosurgery, London, UK.
*
Address for correspondence: Mr G. B. Brookes, Consultant ENT and Neurotological surgeon, Royal National Throat, Nose and Ear Hospital, Gray's Inn Road, London WC1 8DA

Abstract

Vestibular neurectomy is an effective procedure in the management of vertigo due to active labyrinthine disease. Various approaches have been developed for selectively sectioning the vestibular nerve, in order to preserve serviceable hearing and avoid facial nerve injury.

In patients who have a mastoid cavity, from previous surgery for chronic otitis media, the approach to the vestibular nerve has to be modified. Considerations taken into account are cavity infection, hearing status, and the presence of associated loud tinnitus.

Vestibular or vestibulo-cochlear nerve section has been undertaken, by the senior author, in eight patients with a mastoid cavity from previous surgery for chronic otitis media. Translabyrinthine, retrosigmoid and middle fossa approaches have all been used; strategies for selection of each specific technique are considered, and the aetiology of post-chronic suppurative otitis media (CSOM) peripheral vestibular disease discussed.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 1996

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References

Brookes, G. B. (1989). Menière's disease and contralateral chronic suppurative otitis media—An etiological link? In Otolaryngology—Head and Neck Surgery, (Sacristan, T., Alvarez-Vincent, J. J., Bartual, J., Antolf-Candela, F., Rubio, L. eds). Proceedings of the XIV World Congress of Otorhinolaryngology, Head and Neck Surgery, Madrid, Spain, pp 725730.Google Scholar
Garcia-Ibanez, E., Garcia-Ibanez, J. L. (1980). Middle fossa vestibular neurectomy: A report of 373 cases. Otolaryngology—Head and Neck Surgery 88: 486490.Google Scholar
Harris, J. P. (1983). Imunology of the inner ear: response of the inner ear to antigen challenge. Otolaryngology—Head and Neck Surgery 91: 1823.Google Scholar
Jokipii, A. M. M., Karma, P., Ojala, K., Jokipii, L. (1977) Anaerobic bacteria in chronic otitis media. Archives of Otolaryngology 103: 278280.Google Scholar
Kimura, R. S. (1982). Animal models of endolymphatic hydrops. American Journal of Otolaryngology 3(6): 447451.Google Scholar
Kawauchi, H., Lim, D. J., DeMaria, T. F. (1988). Role of middle ear endotoxin in inner ear inflammatory response and hydrops. In Meni`ere's Disease: Pathogenesis, Pathophysiology, Diagnosis and Treatment. Proceedings of the 2nd International symposium on Meniere's disease, Cambridge, MA, USA, pp 113124.Google Scholar
Liston, S. L., Nissen, R. L., Paparella, M. M., DaCosta, S. S. (1991) Surgical treatment of vertigo. In Otolaryngology Vol. II: Otology and Neuro-Otology, 3rd edition. Paparella, M. M., Shumrick, D. A. eds. W. B. Saunders Company, Philadelphia, USA, pp 17151732.Google Scholar
McElveen, J. T. Jr., Brackmann, D. E., Hitselberger, W. E. (1987) Vestibular nerve section in patients with chronic otitis media. American Journal of Otology 8(6): 511515.Google Scholar
Meyerhoff, W. L., Kim, C. S., Paparella, M. M. (1978) Pathology of chronic otitis media. Annals of Otology, Rhinology, Laryngology 87: 749760.Google Scholar
Paparella, M. M., Oda, M., Hiraide, F., Brady, D. (1972). Pathology of sensorineural hearing loss in otitis media. Annals of Otology, Rhinology, and Laryngology 81: 632647.Google Scholar
Paparella, M. M., DeSousa, L. C, Mancini, F. (1983). Menière's syndrome and otitis media. Laryngoscope 93: 14081415.Google ScholarPubMed
Paparella, M. M. (1984). Pathogenesis of Menière's disease and Menière's syndrome. Acta Otolaryngologica (suppl. 406): 1025.Google Scholar
Parikh, A., Brookes, G. B. (1994). Subtotal petrosectomy with external canal overclosure in the management of patients with chronic suppurative otitis media. Journal of Laryngology and Otology 108: 197201.Google Scholar
Rasmussen, A. T. (1940). Studies of the eighth cranial nerve of man. Laryngoscope 50: 6783.Google Scholar
Rask-Anderson, H., Stahle, J. (1980). Immunodefence of the inner ear? Acta Otolaryngologica 89: 283294.Google Scholar
Silverstein, H., Norrell, H. (1982). Retrolabyrinthine vestibular neurectomy. Otolaryngology—Head and Neck Surgery 90: 778782.Google Scholar
Silverstein, H., Norrell, H., Haberkamp, T. (1987). A comparison of retrosigmoid IAC, retrolabyrinthine and middle fossa vestibular neurectomy for treatment of vertigo. Laryngoscope 97: 165172.CrossRefGoogle ScholarPubMed