Transmastoid labyrinthectomy: reliable surgical management of vertigo.

Transmastoid labyrinthectomy has continued to be an important part of the surgical armamentarium for patients with vertigo and nonserviceable hearing loss. Continuing experience substantiates our earlier impression that the vestibular system usually accommodates rapidly to complete unilateral surgical ablation, regardless of age or degree of residual vestibular activity in the ear (as measured by preoperative bithermal caloric testing). Although the symptom of vertigo is reliably treated by transmastoid labyrinthectomy, a patient questionnaire has demonstrated a significant incidence of mild to moderate persisting postoperative dysequilibrium. Although this dysequilibrium is usually not debilitating, this questionnaire has demonstrated its existence more precisely than a retrospective review of the patients' clinical records. This study reviews 110 patients who underwent labyrinthectomy between 1978 and 1985. We remain impressed at the efficacy of the transmastoid labyrinthectomy in relieving the symptom of vertigo.