Vestibular neurectomy vs. chemical labyrinthectomy in the treatment of disabling Meniere's disease: A long-term comparative study

Abstract Objective To compare the efficiency of vestibular neurectomy (VN) and chemical labyrinthectomy (CL) in the treatment of Meniere's disease's disabling vertigo, and to assess their subsequent effects on hearing. Methods This is a retrospective study of 58 VN procedures and 35 CL procedures. Treatment results were assessed by caloric testing and pure-tone audiometry performed before and after treatment. Subjective success was defined by the number of recurrent attacks of vertigo and by the AAO-HNS vertigo scale. Results Caloric testing revealed strong vestibular hyporeflexia in 91.0% of VN cases and 86.0% of CL cases. Vertigo recurred in 7.0% of cases in the VN group and in 11.4% of cases in the CL group. Mean pure-tone auditory thresholds increased from 45.00 dB HL to 50.84 dB HL ( p  = 0.19) in the VN group and from 69.11 dB HL to 74.51 dB HL ( p  = 0.41) in the CL group. Conclusion Vestibular neurectomy and chemical labyrinthectomy offer similar control of vertigo in patients with Meniere's disease. CL is a simple, minimally invasive procedure that emerges as an effective method for treating Meniere's disabling vertigo without causing significant hearing deterioration.