COMPARISON OF LABYRINTHECTOMY AND VESTIBULAR NEURECTOMY IN THE CONTROL OF VERTIGO

One hundred twenty-six patients who were treated with labyrinthectomy (81 patients) or vestibular neurectomy (45) between the years 1979 and 1994 were reviewed, The cause for vertigo in 124 of the 126 patients was Meniere's disease (89 patients), labyrinthitis (15), delayed endol ymphatic hydrops (8), vestibular neuritis (7), and failed labyrinthect omy (5). In the remaining 2 patients, a normal labyrinth was sacrifice d to fistulize a petrous apex cyst, Both procedures were equally effec tive in relieving vertigo (labyrinthectomy 98.8%; neurectomy 97.8%), b ut the length of hospitalization, length of disability before return t o work, and cost were twice as great with vestibular neurectomy than w ith labyrinthectomy, More patients exhibited prolonged ataxia followin g neurectomy (5 patients) than after labyrinthectomy (2), Vestibular n eurectomy was associated with several serious complications: reversibl e facial paresis (15 patients), meningitis (1), cerebrospinal fluid le ak (1), and epidural hematoma (1), Labyrinthectomy was complicated by postoperative hyponatremia in 1 patient, Selective vestibular neurecto my preserved hearing in 32 (82%) of 39 patients, Criteria for recommen ding either ablation procedure are discussed, The incidence of sequent ial involvement of the contralateral ear was 1.5%.