Abstract
We report herein on a case in which a vestibular neurectomy via the middle fossa approach was performed for intractable Meniere's disease. The patient had been treated first with conservative therapy, but her symptoms had not improved. She had undergone endolymphatic sac surgery three times. Since repeated vertigo attacks persisted after that, a vestibular neurectomy was planned. Although preoperative hearing demonstrated severe sensorineural hearing loss, the middle fossa approach was selected due to the expected higher possibility of control of the vertigo. Facial nerve monitoring was used to identify the vestibular nerve during the surgery. There were no postoperative complications like cerebrospinal fluid leakage and facial palsy. Two days after the operation normal walking was possible and the nystagmus disappeared in approximately two weeks. Six months after the operation, there was no vertigo attack.
