Silverstein H, Norrell H, Smouha E, Jones R
Ear Research Foundation, Sarasota, Florida 34239.
Am J Otol. 1989 May;10(3):166-9.
Since introducing the retrolabyrinthine vestibular neurectomy (RVN) in 1978, we have performed 78 procedures with good results. In 1985, we introduced the retrosigmoid-internal auditory canal vestibular neurectomy (RSG-IAC), which allowed a more complete transection of the vestibular nerves in the IAC. Vertigo control has been excellent. However, in 50% of cases postoperative headaches have been a significant problem. In 1987, we combined these two approaches into one procedure, the combined retrolab-retrosigmoid vestibular neurectomy (RSG-RVN). The procedure is similar to a RVN, in that all bone covering the lateral venous sinus (LVS) is removed. It differs from the RVN in that the dura is opened just behind the LVS. The LVS is retracted forward, thereby exposing the cerebellopontine (CP) angle. This allows the surgeon the option to sever the vestibular nerve either in the CP angle or in the IAC, depending on the presence or absence of a cochleovestibular (CV) cleavage plane in the CP angle. The technique, results, and complications will be reported in this article.
自1978年引入迷路后前庭神经切除术（RVN）以来，我们已进行了78例手术，效果良好。1985年，我们引入了乙状窦后-内耳道前庭神经切除术（RSG-IAC），该手术能更完整地横断内耳道内的前庭神经。眩晕控制效果极佳。然而，在50%的病例中，术后头痛一直是个严重问题。1987年，我们将这两种方法结合成一种手术，即联合迷路后-乙状窦后前庭神经切除术（RSG-RVN）。该手术与RVN类似，即切除覆盖外侧静脉窦（LVS）的所有骨质。它与RVN的不同之处在于，在LVS后方切开硬脑膜。将LVS向前牵拉，从而暴露桥小脑（CP）角。这使外科医生可以选择在CP角或内耳道切断前庭神经，具体取决于CP角是否存在蜗神经前庭（CV）分离平面。本文将报告该技术、结果及并发症。
