Transcanal labyrinthectomy for intractable vertigo.

Labyrinthectomy may be the therapy of choice for intractable and disabling vertigo that is caused by unilateral disease of the vestibular labyrinth. The transcanal method through the oval window offers the most direct surgical approach for complete ablation of the vestibular sense organs. The technique includes visual identification and removal of the utricle; this is followed by blind probing of the ampullae. This method was used in 124 patients, including 90 patients with unilateral Meniere's disease. Three of four cases of moderately severe continuing postoperative vertigo were successfully managed by revision transcanal labyrinthectomy. Twenty-seven (22%) of the 124 patients had continuing mild transient unsteadiness associated with quick head movements; this condition is considered to be the physiologic consequence of unilateral loss of vestibular function rather than unremitted disease.