Middle fossa vestibular neurectomy: an update.

Middle fossa section of the vestibular nerve is a neurotologic skull-base procedure that has found a successful, albeit limited, role in the surgical management of Meniere's disease. Incapacitating vertigo can be controlled in 94% of the cases, while serviceable hearing is maintained in 70%. Tinnitus and aural pressure are reduced in 60% and 80% of cases, respectively. The morbidity of this approach is similar to that of other destructive procedures of the labyrinth when careful patient selection and precise surgical technique are employed. In the incapacitated vertiginous patient with serviceable hearing, middle fossa vestibular nerve section should be considered as an alternative to other destructive procedures involving the otic capsule.