This procedure is performed in a patient with unremitting vertigo attacks when the hearing in the affected ear has deteriorated to such an extent that the hearing is no longer useful to the patient. The ear is said to be “non-aidable” meaning that a hearing aid does not work to help the patient understand speech.
This surgery destroys the entire labyrinth, or inner ear for balance. Although the cochlea is left untouched, all the hearing is lost in the ear. It is a wonderful operation for those suffering with vertigo as it eliminates all Meniere’s attacks, but the effect it has on the patient’s balance depends on how much balance function exists in the affected ear and what the balance function is in the good ear, the patient’s health and activity and other conditions affecting balance.
The operation is performed in the hospital, and an admission to the hospital is generally required, the length of which is variable, on average a few days.
A mastoidectomy is performed; the landmarks of the inner ear are identified and then removed surgically with a drill. Intraoperative facial nerve monitoring is performed during the surgery. The patient does not require observation in the intensive care unit, but does require supportive care, medications for nausea and in some cases, physical therapy. The patient is discharged home after he has recovered enough balance to be able to care for himself in his home. A cane or walker is sometimes required for a while after the surgery. Vestibular and balance therapy are usually performed after discharge to allow the patient to recover balance back to normal as quickly as possible.