title: Singular neurectomy update. II. Review of 102 cases.
abstract: During the past 18 years, 102 singular neurectomies (SN) were performed on 95 patients with chronic cupulolithiasis of the posterior canal sense organ. Bilateral sequential singular neurectomies were performed in 7 patients and unilateral singular neurectomies in 88 patients. Ninety-nine (97%) of the 102 singular neurectomies completely eliminated the positional nystagmus and vertigo produced by the involved (undermost) ear in the Hallpike maneuver. Following three singular neurectomies (3%), there was improvement but incomplete relief from the positional nystagmus. A sensorineural hearing loss caused by the singular neurectomies occurred in four patients (4%). A thorough knowledge of the surgical and histologic anatomy of the round window niche and singular canal, together with the use of local anesthesia to allow monitoring of a vestibular response to singular neurectomy are essential for effectiveness and safety.
authors.affiliation: Department of Otolaryngology and Communication Sciences, SUNY Health Science Center, Syracuse 13210.
authors.forename: R R
authors.initials: RR
authors.lastname: Gacek
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D007758:Ear, Inner / Q000294:innervation / Q000601:surgery*; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000209:etiology; D006801:Humans; D008297:Male; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D011187:Posture; D012189:Retrospective Studies; D012405:Round Window, Ear / Q000033:anatomy & histology / Q000601:surgery; D012665:Semicircular Canals / Q000033:anatomy & histology / Q000294:innervation*; D013514:Surgical Procedures, Operative / Q000379:methods; D014717:Vertigo / Q000601:surgery*