Wazen J, Markowitz A, Donatelle C, Post K
Department of Otolaryngology, College of Physicians and Surgeons, Columbia University, New York, NY 10032.
Laryngoscope. 1990 May;100(5):477-80. doi: 10.1288/00005537-199005000-00007.
Thirty-four patients underwent vestibular neurectomies between September 1984 and January 1989. The first 15 patients operated on through January 1987 (and followed for a minimum of 2 years) were evaluated separately for long-term hearing preservation and freedom from vertigo spells. Audiograms taken at 1 postoperative month revealed no change in the pure tone averages of 25 patients and showed improved hearing of 20 to 30 dB in 5 patients. Two patients sustained losses of 18.5 dB and 21 dB, respectively. The speech discrimination scores remained the same in 17 patients, improved in 9, and were reduced in 6. Audiograms performed 12 to 40 months postoperatively showed preservation of the pure tone averages and speech discrimination scores when compared with the earlier 1-month postoperative audiograms in 73% of the patients. The speech discrimination scores, however, tended to fluctuate with the symptomatic course of each disease. Two patients developed major vertigo spells 1 1/2 years following surgery. Postoperative ice-caloric testing revealed no responses in 25 patients and markedly reduced responses in 6. There were no major complications or facial paralysis. The retrolabyrinthine vestibular neurectomy is an effective way to control vertigo with preservation of hearing and an acceptably low incidence of complications and side effects.
1984年9月至1989年1月期间，34例患者接受了前庭神经切除术。对1987年1月前接受手术的前15例患者（并至少随访2年）进行了单独评估，以观察长期听力保留情况及眩晕发作的缓解情况。术后1个月的听力图显示，25例患者的纯音平均值无变化，5例患者听力提高了20至30分贝。2例患者分别听力损失18.5分贝和21分贝。17例患者的言语辨别分数保持不变，9例提高，6例降低。术后12至40个月的听力图显示，与术后1个月时相比，73%的患者纯音平均值和言语辨别分数得以保留。然而，言语辨别分数往往随每种疾病的症状过程而波动。2例患者术后1年半出现严重眩晕发作。术后冷热试验显示，25例患者无反应，6例反应明显减弱。无重大并发症或面瘫发生。迷路后前庭神经切除术是一种控制眩晕的有效方法，可保留听力，并发症和副作用发生率低，可接受。
