When is surgery considered?
Surgery is never the first step. It is a targeted option for people with severe, frequent and disabling attacks of vertigo that do not respond to medication or rehabilitation.
Which conditions can it treat?
- Ménière’s disease
- in forms that do not respond to medication
- Acoustic neuroma (vestibular schwannoma)
- a benign tumour of the nerve of balance and hearing
- Perilymph fistula
- a defect in the bone through which fluid leaks from the inner ear
- Minor’s syndrome
- superior semicircular canal dehiscence, a defect in the bony wall of the labyrinth
Does the operation put hearing at risk?
Preserving hearing is a priority. The choice of technique depends on how much hearing remains in the affected ear, and conservative procedures are always preferred.
What treatments are available?
- Intratympanic injections
- medication (gentamicin or corticosteroids) delivered into the middle ear through the eardrum, without incisions, to stabilise the balance system
- Endolymphatic sac decompression or shunt
- a conservative procedure that lowers the fluid pressure in the inner ear while preserving hearing, typically used in Ménière’s disease
- Vestibular neurectomy
- selective division of the vestibular nerve alone, leaving the auditory nerve and hearing intact
- Surgical or chemical labyrinthectomy
- reserved for cases in which hearing in the affected ear is already severely or completely lost
How is balance recovered?
After surgery, the body begins a natural process called central vestibular compensation, in which the brain learns to rely on the healthy ear. The process is accelerated and guided by a personalised vestibular rehabilitation programme.
What results can be expected?
The aim is to stop sudden attacks of vertigo and restore stability. In the great majority of cases, symptoms are brought under control and patients return to normal daily, social and working life.
This information is provided for general guidance. Every treatment decision is made during a specialist consultation.