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At the 1988 meeting of the American Academy of Otolaryngology–Head and Neck Surgery in Washington, DC, Herbert Silverstein, MD, Sarasota, Fla., presented a modification of the retrolabyrinthine and retrosigmoid approaches for vestibular neurectomy. In this approach, a limited mastoidectomy is performed, and the bone covering the sigmoid and retrosigmoid region is removed. The dural opening is made just behind the sigmoid sinus, and the sinus is retracted anteriorly, exposing the cerebellopontile angle. At this point, the surgeon has the option to section the vestibular nerve within the cerebellopontile angle, if a good cleavage plane exists between the vestibular and cochlear portions of the cochleovestibular nerve. If the cleavage plane between the cochlear and vestibular divisions is obscured, the surgeon proceeds with bony removal of the posterior aspect of the internal auditory canal and sections the vestibular portion of the vestibular cochlear nerve.
The reason for this modification in technique is
MCELVEEN JT. Retrolabyrinthine Retrosigmoid Vestibular Neurectomy: An Evolution in Approach. Arch Otolaryngol Head Neck Surg. 1989;115(7):776. doi:10.1001/archotol.1989.01860310014005