Singular neurectomy: hypotympanotomy approach.

A modified surgical technique is described for singular neurectomy. The hypotympanotomy approach provides greater ease in exposing the singular canal. Delayed round window overhang removal provides decreased risk of round window trauma. Eight cases done by this technique indicated a lower complication rate than any reported transmeatal series. Selection criteria, results, and complications are discussed. The risk of cochlear damage limits singular neurectomy to patients who are severely incapacitated by benign paroxysmal positional vertigo. Compared with vestibular neurectomy, singular neurectomy avoid risks inherent in intracranial procedures, and the vertigo caused by surgical intervention is less pronounced.