{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T23:33:56Z","timestamp":1792020836432,"version":"4.4.0"},"reference-count":28,"publisher":"MDPI AG","issue":"4","license":[{"start":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T00:00:00Z","timestamp":1712793600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: Meniere\u2019s disease (MD) is a disabling disease, especially in patients who are refractory to medical therapy. Moreover, selective vestibular neurectomy (VN), in these selected cases, can be considered a surgical alternative which preserves hearing function and facial nerve. Methods: We retrospectively studied 23 patients with MD diagnosis and history of failed extradural endolymphatic sac surgery (ELSS) who underwent combined micro-endoscopic selective VN, between January 2019 and August 2023, via a presigmoid retrolabyrinthine approach. All patients were stratified according to clinical features, assessing preoperative and postoperative hearing levels and quality of life. Results: At the maximum present follow-up of 2 years, this procedure is characterized by a low rate of complications and about 90% vertigo control after surgery. No definitive facial palsy or hearing loss was described in this series. One patient required reintervention for a CSF fistula. Statistically significant (p = 0.001) difference was found between the preoperative and the postoperative performance in terms of physical, functional, and emotive scales assessed via the DHI questionnaire. Conclusions: Selective VN via a presigmoid retrolabyrinthine approach is a safe procedure for intractable vertigo associated with MD, when residual hearing function still exists. The use of the endoscope and intraoperative neuromonitoring guaranteed a precise result, saving the cochlear fibers and facial nerve. The approach for VN is a familiar procedure to the otolaryngologist, as is lateral skull base anatomy to the neurosurgeon; therefore, the best results are obtained with multidisciplinary teamwork.<\/jats:p>","DOI":"10.3390\/brainsci14040369","type":"journal-article","created":{"date-parts":[[2024,4,11]],"date-time":"2024-04-11T03:29:04Z","timestamp":1712806144000},"page":"369","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Selective Vestibular Neurectomy through the Presigmoid Retrolabyrinthine Approach in the Treatment of Meniere\u2019s Disease"],"prefix":"10.3390","volume":"14","author":[{"given":"Fabrizio","family":"Salvinelli","sequence":"first","affiliation":[{"name":"UOC di Otorinolaringoiatria, Fondazione Policlinico Universitario Campus Bio-Medico, 60126 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Bonifacio","sequence":"additional","affiliation":[{"name":"UOC di Otorinolaringoiatria, Fondazione Policlinico Universitario Campus Bio-Medico, 60126 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mara","family":"Capece","sequence":"additional","affiliation":[{"name":"Clinica Universitaria di Neurochirurgia, Universit\u00e0 Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9293-5185","authenticated-orcid":false,"given":"Denis","family":"Aiudi","sequence":"additional","affiliation":[{"name":"Clinica Universitaria di Neurochirurgia, Universit\u00e0 Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4514-0704","authenticated-orcid":false,"given":"Alessio","family":"Iacoangeli","sequence":"additional","affiliation":[{"name":"Clinica Universitaria di Neurochirurgia, Universit\u00e0 Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fabio","family":"Greco","sequence":"additional","affiliation":[{"name":"UOC di Otorinolaringoiatria, Fondazione Policlinico Universitario Campus Bio-Medico, 60126 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Gladi","sequence":"additional","affiliation":[{"name":"Clinica Universitaria di Neurochirurgia, Universit\u00e0 Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maurizio","family":"Iacoangeli","sequence":"additional","affiliation":[{"name":"Clinica Universitaria di Neurochirurgia, Universit\u00e0 Politecnica delle Marche, Azienda Ospedaliero Universitaria delle Marche, 60126 Ancona, Italy"},{"name":"Istituto di Ricovero e Cura a Carattere Scientifico\u2014Istituto Nazionale di Ricovero e Cura per Anziani (IRCCS\u2014INRCA), 60127 Ancona, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,4,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1943","DOI":"10.1007\/s00405-019-05423-7","article-title":"Therapeutic strategies in the treatment of Meni\u00e8re\u2019s disease: The Italian experience","volume":"276","author":"Quaranta","year":"2019","journal-title":"Eur. 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