Kemink J L, Telian S A, el-Kashlan H, Langman A W
Department of Otolaryngology-Head and Neck Surgery, University of Michigan Medical Center, Ann Arbor 48109.
Laryngoscope. 1991 May;101(5):523-8. doi: 10.1288/00005537-199105000-00015.
The retrolabyrinthine vestibular nerve section has evolved as an effective treatment for intractable vertigo of peripheral vestibular origin when hearing preservation is desired. This report studies the efficacy of retrolabyrinthine vestibular nerve section for control of vertigo due to causes other than Meniere's disease. This report details our experience with 42 patients with a wide variety of diagnoses. The reduced success rate of retrolabyrinthine vestibular nerve section in these patients is difficult to evaluate, as very few patients have been analyzed with respect to their specific diagnoses. Of patients who underwent retrolabyrinthine vestibular nerve section for control of vertigo, 23 patients had uncompensated vestibular neuritis and 19 others had a wide range of other diagnoses. For patients with uncompensated vestibular neuritis (n = 23), the physician record noted that 39% of patients were cured and 30% improved. This compares to our series of patients with Meniere's disease (n = 48), where 94% were cured and 2% improved. The true vestibular abnormality may be less reliably identified in patients with uncompensated vestibular neuritis, contributing to the less effective results. Since the development of a vestibular rehabilitation program, retrolabyrinthine vestibular nerve section for uncompensated vestibular neuritis has been all but abandoned. Retrolabyrinthine vestibular nerve section appears to achieve a high cure rate in patients with sensorineural hearing loss associated with their vestibular abnormalities. While retrolabyrinthine vestibular nerve section is helpful for control of vertigo in some diagnoses, a substantial incidence of persistent postoperative dysequilibrium was noted.
当期望保留听力时，迷路后前庭神经切断术已发展成为治疗外周性前庭源性顽固性眩晕的一种有效方法。本报告研究迷路后前庭神经切断术对梅尼埃病以外原因所致眩晕的控制效果。本报告详细介绍了我们对42例诊断各异患者的治疗经验。由于很少有患者针对其具体诊断进行分析，因此难以评估这些患者中迷路后前庭神经切断术成功率的降低情况。在接受迷路后前庭神经切断术以控制眩晕的患者中，23例患有未代偿性前庭神经炎，另外19例有一系列其他诊断。对于患有未代偿性前庭神经炎的患者（n = 23），医生记录显示39%的患者治愈，30%的患者病情改善。相比之下，我们的梅尼埃病患者系列（n = 48）中，94%的患者治愈，2%的患者病情改善。在未代偿性前庭神经炎患者中，真正的前庭异常可能较难可靠识别，这导致了效果较差。自从开展前庭康复计划以来，迷路后前庭神经切断术治疗未代偿性前庭神经炎几乎已被摒弃。迷路后前庭神经切断术似乎在伴有前庭异常的感音神经性听力损失患者中能达到较高的治愈率。虽然迷路后前庭神经切断术在某些诊断中有助于控制眩晕，但术后持续性平衡失调的发生率较高。
