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October 1987

Why Do Vestibular Destructive Procedures Sometimes Fail?

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Arch Otolaryngol Head Neck Surg. 1987;113(10):1043-1046. doi:10.1001/archotol.1987.01860100021008

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In an attempt to answer the aforementioned question, Edwin M. Monsell, MD, PhD, of the Chicago Otology Group, Hinsdale, Ill, and Derald Brackmann, MD, and Fred Linthicum, Jr, MD, of the Otologic Medical Group and House Ear Institute, Los Angeles, reviewed the clinical histories obtained from patients failing vestibular ablative procedures at the April meeting of the American Neurotology Society, Denver. Furthermore, vestibular nerve specimens and one temporal bone from this patient population were studied by light microscopy.

The authors identified persistence of the central processes of primary vestibular neurons in three specimens

obtained from patients who had ongoing symptoms and ice-water caloric responses after retrolabyrinthine vestibular neurectomy. It was their opinion that this was due to incomplete neurectomy and anatomic variations in the plane of separation of the vestibular and cochlear portions of the eighth nerve in the posterior fossa.

Moreover, noting that persistent disabling unsteadiness has been reported

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