Transmastoid labyrinthectomy for disabling vertigo in a patient with internal auditory canal pathology.
OBJECTIVE
Document the use of transmastoid labyrinthectomy to treat disabling vertigo secondary to a lesion in the internal auditory canal.


METHODS
A 69-year-old man with nonserviceable left hearing experienced disabling attacks of vertigo refractory to medical measures. Magnetic resonance imaging revealed a small left intracanalicular lesion with an irregular configuration and modest enhancement, suggesting either an unusual acoustic neuroma or a cavernoma. Tumor size remained stable on serial imaging, and the patient declined microsurgical resection, stereotactic radiation, or intratympanic gentamicin therapy.


METHODS
Transmastoid labyrinthectomy followed by a customized vestibular rehabilitation program.


METHODS
Comparison of patient symptoms preoperatively and at 5 and 8 months after surgery.


RESULTS
Complete relief of vertigo was achieved, but the patient has moderate imbalance postoperatively.


CONCLUSIONS
Transmastoid labyrinthectomy alone may be a viable treatment option in patients with an internal auditory canal neoplasm causing disabling attacks of vertigo.
Division of Otology and Neurotology, Department of Otolaryngology-Head and Neck Surgery, University of Michigan Health System, Ann Arbor, Michigan 48109-5312, USA. kheidenr@med.umich.edu
Katherine D
KD
Heidenreich
Garrett R
GR
Griffin
Mark B
MB
Lorenz
Steven A
SA
Telian
D000368:Aged; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D009464:Neuroma, Acoustic / Q000150:complications / Q000601:surgery; D013506:Otologic Surgical Procedures / Q000379:methods*; D014012:Tinnitus / Q000209:etiology / Q000601:surgery; D016896:Treatment Outcome; D014717:Vertigo / Q000209:etiology / Q000601:surgery*; D014722:Vestibule, Labyrinth / Q000601:surgery*