Vestibular Neurectomy Proves Highly Effective for Severe Meniere's Disease, unravels study

In this study there were 20 unilateral Meniere's patients who underwent vestibular neurectomy. Evaluations before and two years after the surgery were done in order to detect the outcome of the treatment applied. The evaluation consisted of subjective grading according to the American Academy Otolaryngology-Head and Neck Surgery's scale and Dizziness Handicap Inventory (DHI). Also, the Sensory Organization Test (SOT) was applied to the sensory interaction portion of the balance system before and after surgery.

Key Findings

• All 20 patients (100%) reported complete resolution of vertigo attacks following vestibular neurectomy.

• According to the American Academy of Otolaryngology-Head and Neck Surgery’s grading scale, 95% of patients reported a significant improvement in their functional level. The average score decreased from 4.5 preoperatively to 1.6 postoperatively.

• Scores on the DHI, which should be representative of overall impacts of dizziness on daily activities, improved dramatically.

• The mean score reduced from 81.7 in the pre-surgery phase to 16.4 in the post-surgery phase thus indicating the significant drop in the handicap by dizziness.

• The results of the Sensory Organization Test did not change statistically significantly before and after surgery, suggesting that, while the vertigo was resolved, overall functioning of the balance system remained stable.

• The research also showed there were significant correlations between patient age and the postoperative results based on the DHI and posturography tests, thus indicating that age may have an influence on how much recovery and adaptation is expected to be derived from surgery.

These results emphasize the overall efficacy of vestibular neurectomy for treating severe Meniere's disease, particularly in all patients who have otherwise failed conservative management. Surgery did not merely abolish vertigo attacks but also evidenced significant gains in functional and emotional well-being with a steep decline in DHI scores. Generally, most of the patients returned back to daily activities and work, which signifies the restorative potential of the procedure in regard to quality of life.

On the other hand, this study stressed that careful selection of the patient and rigorous pre-operative evaluation are very essential. One has to know the general status of health, age, and particular characteristics of Meniere's disease in order to achieve optimal surgical outcomes. Little changes within the Sensory Organization Test may indicate that, on the one hand, vestibular neurectomy is an efficient treatment in the control of vertigo, but on the other hand, it does not drastically change the functioning of the balance system, which remains dependent on individual compensatory mechanisms.

This study concludes that vestibular neurectomy is a highly effective surgical option for patients with severe Meniere’s disease who do not respond to conservative management. The procedure provides substantial relief from vertigo, improves physical and emotional well-being, and allows patients to regain their daily functions. These findings support the role of vestibular neurectomy as a valuable intervention in the management of Meniere’s disease.

Reference:

Jasińska-Nowacka, A., Lachowska, M., & Niemczyk, K. (2024). Functional level and dynamic posturography results two years after vestibular neurectomy in patients with severe Meniere’s disease. Journal of Clinical Medicine, 13(12), 3362. https://doi.org/10.3390/jcm13123362