Long-term results of vestibular nerve section

Records are available on 27 patients who had vestibular nerve section betwe en 1975 and 1987 giving a follow-up time of 10 to 22 years with a mean of 1 6 years. Episodic vertigo was fully controlled in 26 patients, one needing a labyrinthectomy 18 months later. In addition to the patient who had labyrinthectomy, one patient had immedia te post-operative profound hearing loss so that long-term follow-up of hear ing was possible in 25 patients. After six months there was an overall aver age improvement in hearing of 1 dB. Thereafter then were average deteriorat ion of 7 dB at two years, 15 dB at 10 years, 23 dB at 15 years and 29 dB at 20 years. This deterioration was more marked in those who had better heari ng at the time of surgery, with all 10 whose hearing was classified as good deteriorating to poor by 15 years. At 10 years hearing deteriorated by 25 dB in those with good hearing and by 7 dB in those with poor hearing. In 20 per cent of patients there was audiological evidence of eventual involveme nt of the other ear. Tinnitus became worse in five patients but was a major problem in only one patient. One patient suffered a facial paralysis with partial recovery and, in addition, in one the frontal branch was divided in the incision.