Silverstein H, White D W
Ear Research Foundation, Sarasota, Fla. 34239.
Laryngoscope. 1990 Jul;100(7):701-6. doi: 10.1288/00005537-199007000-00005.
Since 1972, singular neurectomy has been performed on 58 patients who had classical benign positional vertigo. The procedure is done under general anesthesia; a wide postauricular exposure is made and the external auditory canal is maximally enlarged until the vertical portion of the facial nerve is identified. This gives an excellent view of the round window niche. Our results indicate vertigo was completely cured in 80% of the cases and improved in 17%. There has been no incidence of total hearing loss in the last 49 cases and only 3 of 49 patients (6%) had sensorineural loss. Although singular neurectomy can be mastered, it will remain a procedure done by few surgeons. The wide exposure technique is safer for preservation of cochlear function and the posterior ampullary nerve is easier to find than using the transmeatal approach as described by Gacek.
自1972年以来，对58例患有典型良性阵发性位置性眩晕的患者实施了单神经切除术。该手术在全身麻醉下进行；做一个广泛的耳后切口暴露，并最大程度地扩大外耳道，直至识别出面神经的垂直部分。这样可以很好地看到圆窗龛。我们的结果表明，80%的病例眩晕完全治愈，17%的病例有所改善。在最近的49例病例中没有出现全聋情况，49例患者中只有3例（6%）出现感音神经性听力损失。尽管单神经切除术可以掌握，但仍将是少数外科医生实施的手术。这种广泛暴露技术对保留耳蜗功能更安全，并且后壶腹神经比使用Gacek描述的经耳道入路更容易找到。
