{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,15]],"date-time":"2026-09-15T22:42:36Z","timestamp":1789512156050,"version":"build-2803163510"},"reference-count":40,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2022,10,1]]},"abstract":"<jats:sec>\n<jats:title>OBJECTIVE<\/jats:title>\n<jats:p>When M\u00e9ni\u00e8re\u2019s disease (MD) becomes disabling due to the frequency of attacks or the appearance of drop attacks (i.e., Tumarkin otolithic crisis) despite \"conservative\" medical and surgical treatments, a radical treatment like vestibular neurotomy (VN) is possible. An ideal MD treatment would relieve symptoms immediately and persist after the therapy. The aim of this study was to identify if VN was effective after 10 years of follow-up regarding vertigo and drop attacks, and to collect the immediate complications.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>METHODS<\/jats:title>\n<jats:p>The authors report a retrospective, single-center (i.e., in a single tertiary referral center with otoneurological surgery activity) cohort study conducted from January 2003 to April 2020. All patients with unilateral disabling MD who had received a VN with at least 10 years of follow-up were included. The therapeutic efficacy was defined by complete disappearance of vertigo and drop attacks. The postoperative complications (CSF leak, total deafness, meningitis, death) were determined immediately after the surgery, and the hearing thresholds were determined during the patient follow-up with the pure tone average (PTA).<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>RESULTS<\/jats:title>\n<jats:p>A total of 74 patients (of 85 who were eligible), average age 51.9 \u00b1 11.1 years, including 38 men (51.4%), with disabling MD and\/or Tumarkin drop attacks (24.3%) received VN, with at least 10 years of follow-up after surgery. After an average follow-up of 12.4 \u00b1 1.7 years (range 10.0\u201316.3 years), 67 patients (90.5%) no longer presented any vertiginous attacks, and no patient experienced drop attack. The mean variation in early pre- and postoperative PTA was not statistically significant (n = 64, 2.2 \u00b1 10.3 decibels hearing level [range \u221218 to 29], 95% CI [\u22120.4 to 4.37]; p = 0.096), and 84.4% of the patients evaluated had unchanged or improved postoperative PTA. Three significant complications were noted, including two surgical revisions for CSF leak. There was no permanent facial paralysis, meningitis, or death.<\/jats:p>\n<\/jats:sec>\n<jats:sec>\n<jats:title>CONCLUSIONS<\/jats:title>\n<jats:p>In case of disabling MD (disabling vertigo refractory to conservative vestibular treatments\u2014Tumarkin drop attacks), VN via the retrosigmoid approach must be the prioritized proposal in comparison to intratympanic gentamicin injections, because of the extremely low complication rate and the immediate and long-lasting effect of this treatment on vertigo and falls.<\/jats:p>\n<\/jats:sec>","DOI":"10.3171\/2021.10.jns21145","type":"journal-article","created":{"date-parts":[[2022,1,7]],"date-time":"2022-01-07T08:06:02Z","timestamp":1641542762000},"page":"1034-1040","source":"Crossref","is-referenced-by-count":16,"title":["Long-term efficacy of vestibular neurotomy in disabling M\u00e9ni\u00e8re\u2019s disease and Tumarkin drop attacks"],"prefix":"10.3171","volume":"137","author":[{"given":"Yohanan","family":"V\u00e9leine","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Division, Robert Debr\u00e9 Hospital, Reims University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esteban","family":"Brenet","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Division, Robert Debr\u00e9 Hospital, Reims University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"Labrousse","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Division, Robert Debr\u00e9 Hospital, Reims University Hospital;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andr\u00e9","family":"Chays","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Division, Robert Debr\u00e9 Hospital, Reims University Hospital;"},{"name":"Otoneurosurgical Institute of Champagne-Ardenne, Head and Neck Division, Maison Blanche Hospital, Reims University Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arnaud","family":"Bazin","sequence":"additional","affiliation":[{"name":"Otoneurosurgical Institute of Champagne-Ardenne, Head and Neck Division, Maison Blanche Hospital, Reims University Hospital; and"},{"name":"Department of Neurosurgery, Head and Neck Division, Maison Blanche Hospital, Reims University Hospital, Reims, Grand Est Region, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean-Charles","family":"Kleiber","sequence":"additional","affiliation":[{"name":"Otoneurosurgical Institute of Champagne-Ardenne, Head and Neck Division, Maison Blanche Hospital, Reims University Hospital; and"},{"name":"Department of Neurosurgery, Head and Neck Division, Maison Blanche Hospital, Reims University Hospital, Reims, Grand Est Region, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xavier","family":"Dubernard","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Head and Neck Division, Robert Debr\u00e9 Hospital, Reims University Hospital;"},{"name":"Otoneurosurgical Institute of Champagne-Ardenne, Head and Neck Division, Maison Blanche Hospital, Reims University Hospital; and"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"7","key":"b1","series-title":"Acta Neurochir (Wien)","doi-asserted-by":"publisher","first-page":"655","DOI":"10.1007\/s00701-007-1462-0","article-title":"Evaluation of retrosigmoid vestibular neurectomy for intractable vertigo in M\u00e9ni\u00e8re\u2019s disease: an interdisciplinary review","volume":"150","author":"Li CS","year":"2008","unstructured":"Li CS, Lai JT. 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