Infralabyrinthine approach to vestibular neurectomy in Menière's disease.

The infralabyrinthine approach to vestibular neurectomy was performed in 9 patients with unilateral Menière's disease. According to the AAOO (1972) criteria, 7 of 9 cases were graded as class B and the remaining 2 cases as class C. Otherwise, according to the AAO-HNS (1985) criteria, 6 patients who could be followed over 2 years were all graded as 'complete' at the vertigo control. The compensation of the spontaneous vestibular signs was rapid in the first 2 postoperative weeks, though an occasional imbalance on movement persisted even 3 years after the operation. No specific caloric reaction was elicited in any patient after warm or cold water irrigation of the operated side in any postoperative period. There have been no serious complications except a delayed facial palsy that appeared in one case one week after surgery. This approach offers access to the vestibular nerve with minimal risk and morbidity.