[Endoscopic technique utilized into the selective vestibular neurotomy by retrosigmoid approach].
OBJECTIVE
To investigate the micro-wound technique and the signification of reducing brain tissue oppression and complication at the surgery with utilizing endoscopic technique during the operation of selective vestibular neurotomy (SVNT) by retrosigmoid approach.


METHODS
Twelve patients were preceded the SVNT by retrosigmoid approach (as routine operation group, ROG), and nine patients were utilized endoscope for review and neurotomy during the process of the SVNT by retrosigmoid approach (as endoscopic operation group, EOG). All of them were examined by auditory level, vestibular function, facial nerve function and observed of clinical situation (including complication and equilibrium function and so on) before and after operation.


RESULTS
Two patients appeared cerebral edema and demanded the treatment of dehydration and depressing intracranial pressure in ROG after operation. In each group, the average auditory threshold in 2 patients rose more than 15 dB post-operation. The interval time of average equilibrium function compensation is (29.00 +/- 9.60) d in ROG and (28.56 +/- 7.91) d in EOG after surgery. Peripheral facial paralysis didn't happen to any patient in two groups. After follow-up two years post-operation, the vertigo recurred in 2 patients (4 times and 1 times, respectively) in ROG and 1 patient (2 times) in EOG.


CONCLUSIONS
The SVNT by retrosigmoid approach is widespread adopted presently as expedience and safe surgery method for Ménière's disease, and could effectively eliminate vertigo and simultaneously conserve the hearing function and the integration of facial nerve. This surgery process became micro-wound, more facility and safe following the endoscopic technique utilization, which could reduce the brain tissues depression and trauma and could not cause any of complications. Therefore, the endoscopic operation of the SVNT by retrosigmoid approach is worth to clinically popularize as the therapy method of vertigo for the patients of Ménière's disease, especially who associate with contralateral sensorineural hearing loss.
Tan
Chang-qiang
CQ
Department of Otorhinolaryngology, Affiliated Zhong Da Hospital of Southeast University, Nanjing 210009, China. otology@vip.sina.com
Brookes
G B
GB
D000328:Adult; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000601:surgery*; D019635:Neurosurgical Procedures; D013506:Otologic Surgical Procedures / Q000379:methods*; D014717:Vertigo / Q000601:surgery; D014725:Vestibular Nerve / Q000601:surgery*