Vestibular neurectomy vs. chemical labyrinthectomy in the treatment of disabling Menière's disease: a long-term comparative study.
OBJECTIVE
To compare the efficiency of vestibular neurectomy (VN) and chemical labyrinthectomy (CL) in the treatment of Menière's disease's disabling vertigo, and to assess their subsequent effects on hearing.


METHODS
This is a retrospective study of 58 VN procedures and 35 CL procedures. Treatment results were assessed by caloric testing and pure-tone audiometry performed before and after treatment. Subjective success was defined by the number of recurrent attacks of vertigo and by the AAO-HNS vertigo scale.


RESULTS
Caloric testing revealed strong vestibular hyporeflexia in 91.0% of VN cases and 86.0% of CL cases. Vertigo recurred in 7.0% of cases in the VN group and in 11.4% of cases in the CL group. Mean pure-tone auditory thresholds increased from 45.00dB HL to 50.84dB HL (p=0.19) in the VN group and from 69.11dB HL to 74.51dB HL (p=0.41) in the CL group.


CONCLUSIONS
Vestibular neurectomy and chemical labyrinthectomy offer similar control of vertigo in patients with Menière's disease. CL is a simple, minimally invasive procedure that emerges as an effective method for treating Menière's disabling vertigo without causing significant hearing deterioration.
Schmerber
Sébastien
S
Department of Otorhinolaryngology, Grenoble University Medical Center, BP 217 - 38043 Grenoble Cedex 9, France. SSchmerber@chu-grenoble.fr
Dumas
Georges
G
Morel
Nils
N
Chahine
Karim
K
Karkas
Alexandre
A
D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D002150:Caloric Tests; D004056:Differential Threshold; D006233:Persons with Disabilities; D007758:Ear, Inner / Q000187:drug effects*; D005260:Female; D006309:Hearing; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis / Q000503:physiopathology* / Q000628:therapy*; D008875:Middle Aged; D013506:Otologic Surgical Procedures / Q000009:adverse effects; D012008:Recurrence; D012021:Reflex, Abnormal; D012189:Retrospective Studies; D016896:Treatment Outcome; D014725:Vestibular Nerve / Q000601:surgery*; D055815:Young Adult