Haid T
HNO-Klinik, Universität Erlangen-Nürnberg.
HNO. 1988 Aug;36(8):308-14.
In cases of vertigo resistant to conservative treatment, surgery can be valuable for labyrinthine fistula, perilymphatic fistula, cupulolithiasis and Menière's disease. For instance, covering a labyrinthine fistula by a fascial graft relieves the vertigo in an amazingly short time. Perilymphatic fistula is verified and treated by tympanotomy and is used for patients with special auditory and/or vestibular features. Cupulolithiasis usually requires no surgical treatment: special postural training will speed recovery, but a few cases need neurectomy of the inferior vestibular nerve. There are several methods of surgical treatment for Menière's disease. In our experience neurectomy of the superior and inferior vestibular nerves on the diseased side together with decompression of the eighth cranial nerve via an extended transtemporal approach to the middle fossa is an excellent method of treating patients with vertigo attacks.
对于保守治疗无效的眩晕病例，手术对于迷路瘘管、外淋巴瘘、壶腹嵴顶耳石症和梅尼埃病可能具有重要价值。例如，用筋膜移植覆盖迷路瘘管可在极短时间内缓解眩晕。外淋巴瘘通过鼓室切开术进行确诊和治疗，适用于具有特殊听觉和/或前庭特征的患者。壶腹嵴顶耳石症通常无需手术治疗：特殊的体位训练可加速恢复，但少数病例需要进行下前庭神经切除术。梅尼埃病有多种手术治疗方法。根据我们的经验，通过扩大颞部入路至中颅窝对患侧上下前庭神经进行切除并同时对第八颅神经进行减压，是治疗眩晕发作患者的一种极佳方法。
