Analysis of surgical procedures in patients with vertigo.

The majority of patients with vertigo secondary to inner ear problems can be cured by surgery (80%). The results after neurectomy procedures such as cochleovestibular neurectomy or vestibular neurectomy appear to be much better (85%) than after the endolymphatic subarachnoid shunt procedure (70%). If hearing is worth saving, a conservative procedure should be used first in an effort to preserve the patient's hearing. If this fails, a cochleovestibular neurectomy will usually resolve the problem. At present we are using the retrolabyrinthine vestibular neurectomy as a primary procedure for Meniere's disease, reserving the cochleovestibular neurectomy for those in whom the vestibular neurectomy failed. In elderly patients it appears the Schuknecht cochleosacculotomy may have promise as a first procedure for control of vertigo.