Headache prevention in retrosigmoid vestibular nerve section

Most disorders of the inner ear resulting in vertigo can be managed medically with good results. Meniere's disease, one of the more common causes of recurring vertigo, does not respond adequately to medical management in 5% of the cases. These patients become candidates for surgical management. Selective vestibular nerve section has become the procedure of choice when one desires to preserve residual hearing. This paper reviews 22 cases of vestibular nerve section via a retrosigmoid approach. The disease entities treated, treatment results, operative morbidity, and complications are tabulated. The surgical technique is discussed in detail. The goals in reviewing these cases were to evaluate the impression that the incidence of severe and/or prolonged postoperative headache was infrequent and to compare surgical results with those reported by others in the literature.