■ OBJECTIVES: It is well known that vestibular nerve section via retrosigmoid approach is a safe and effective surgical procedure for the control of vertigo and hearing preservation in intractable Meniere’s disease, with a low rate of complications. We aimed to analyze in this study the impact of vestibular neurotomy (VN) on, first the evolution of the hearing loss and second, to the rate of contralateral disease (bilateral Menière’s disease, BMD).

■ METHODS: We used the following criteria to define bilaterality: the recurrence of attacks of the three typical symptoms of the disease at the one side and a fluctuating or not, associated simultaneously to a sensorineural low-frequency hearing loss on the contralateral side. From 328 patients with Meniere’s disease who underwent VN from 1993 to 2006, we have reviewed 18 patients who presented contralateral symptoms. Three different groups of patients were defined following their evolution and treatment: Group I, includes 5 patients with unilateral involvement of the disease at the time of surgery who presented BMD postoperatively; Group II, includes 11 patients with BMD before VN, and Group III includes 2 patients with bilateral involvement, who underwent bilateral VN. We compared the prevalence of BMD in our population and in the literature. We also analyzed the evolution of the hearing in the three different groups.

■ RESULTS: Complete control of vertigo was achieved in 17/18 patients (94,45%). From the 328 patients with Meniere’s disease who underwent VN, 12 presented a bilateral disease 1 to 24 months before surgery (mean time 8,25 months). From the 316 other patients, 6 patients presented bilateral involvement from 2 months to 22 years after surgery. That represents a 1,9% rate of BMD developed postoperatively. VN showed to stabilize the auditory threshold in the immediate postoperative time but not at late follow-up.

■ CONCLUSIONS: Our study shows the positive effect of VN in reducing the incidence of bilaterality among the unilateral operated patients comparing to the natural outcome of Meniere’s disease (10- 35%). In patients with bilateral involvement of the disease, unilateral VN reduces the rate of hearing impairment on both the operated and the contralateral side.