VESTIBULAR NERVE-SECTION FOLLOWING PREVIOUS MASTOIDECTOMY

Vestibular neurectomy is an effective procedure in the management of v ertigo due to active labyrinthine disease. Various approaches have bee n developed for selectively sectioning the vestibular nerve, in order to preserve serviceable hearing and avoid facial nerve injury. In pati ents who have a mastoid cavity, from previous surgery for chronic otit is media, the approach to the vestibular nerve has to be modified. Con siderations taken into account are cavity infection, hearing status, a nd the presence of associated loud tinnitus. Vestibular or vestibulo-c ochlear nerve section has been undertaken, by the senior author, in ei ght patients with a mastoid cavity from previous surgery for chronic o titis media. Translabyrinthine, retrosigmoid and middle fossa approach es have all been used; strategies for selection of each specific techn ique are considered, and the aetiology of post-chronic suppurative oti tis media (CSOM) peripheral vestibular disease discussed.