[Value of vestibular neurectomy using the suprapetrosal approach in the treatment of Menière's disease].
Results of a suprapetrosal approach to vestibular neurectomy for the treatment of Meniere's disease in 60 patients between 1974 and 1984 (ORL clinic, Lille) demonstrated the benign nature of the operation and its efficacy (94.5% recovery rate). However, deafness is in no way altered, there is a relatively high risk of severe paralysis (3 patients--approximately 5%) and sequelae consist of typical facial hemispasm. The operation should be reserved for patients with severe Meniere's disease resistant to medical treatment. It is a difficult surgical procedure requiring a minutiose technique with identification of all guides described in the literature (blue line of superior semicircular canal and angle of Fisch, petrosal nerves, superior petrosal sinus). This operation is preferred to that of other approaches (retrolabyrinthic and retrosigmoid), since section of vestibular nerves in the pontocerebellar angle involves a greater theoretical vital risk (particularly by possible lesion of the vascular system of cerebellar arteries) and a risk of postoperative liquorrhea. Long-term risks are dominated by onset of bilateralization of the disease, an event which is however only moderately frequent (10% of patients).
D000328:Adult; D000368:Aged; D003638:Deafness / Q000209:etiology; D005158:Facial Paralysis / Q000209:etiology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000601:surgery*; D008722:Methods; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology; D014725:Vestibular Nerve / Q000601:surgery*
Intérêt de la neurectomie vestibulaire par voie sus-pétreuse dans le traitement de la maladie de Ménière.