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Neurochirurgie
Volume 65, n° 1
pages 20-26 (février 2019)
Doi : 10.1016/j.neuchi.2018.11.002
Received : 18 June 2018 ;  accepted : 22 November 2018
Articles originaux

Postoperative compensation after neurotomy in Meniere's disease: Retrospective study of 15 cases
 

L. Lemnos a, K. Aubry b, J.-J. Moreau a, F. Caire a, H. Salle a,
a Service de neurochirurgie, CHU de Limoges, 87000 Limoges, France 
b Service d’ORL, CHU de Limoges, 87000 Limoges, France 

Corresponding author.
Abstract
Introduction

Vestibular neurotomy is a functional surgery for Meniere's disease in the event of medical treatment failure. The aim of the study was to assess the efficacy and complications of vestibular neurotomy, and to address the question of postoperative compensation.

Material and method

All patients included in this retrospective study underwent a vestibular neurotomy at our center between 2009 and 2016. A preoperative evaluation was performed including MRI, audiometry, and videonystagmography. The functional level of disability was evaluated by the Dizziness Handicap Inventory (DHI) score. In all patients suboccipital retrosigmoid approach was performed. All patients underwent early postoperative vestibular rehabilitation. One month and two years after surgery, we assessed the effectiveness of treatment on dizziness, disability and imbalance. At the time of this study (2 to 8 years), DHI and patients’ satisfaction by patient's global impression of change (PGIC) scale were evaluated.

Results

Fifteen patients aged between 42 and 74 years of age were included in our study. Postoperative complications occurred in two patients (meningitis and a wound infection). At one month, all patients had a dramatic clinical improvement with decreased vertigo. Two years after surgery, 85% of the patients were cured and had no dizziness or balance disorder. Only one patient experienced bilateralization and only one had a persistent poor compensation.

Conclusion

Vestibular neurotomy is a very effective treatment in the case of Meniere's disease resistant to medical treatment, with very good functional results and an extremely low failure rate.

The full text of this article is available in PDF format.

Keywords : Meniere's disease, Vestibular neurotomy, Compensation, Bilateralization

Abbreviations : MD, AAO-HNS, ABR, DHI, CSF, PGIC




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