The Efficacy of Microvascular Decompression in Disabling Positional Vertigo / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Disabling positional vertigo (DPV) refers to the cross-compression of the eighth cranial nerve from vessels in the posterior fossa which causes symptoms of vestibular disturbances. The most common symptom is a whirling sensation that is worse when the head is in a specific position and is abated with total bed rest. Many patients with DPV also have symptoms of auditory nerve and/or adjacent cranial nerve involvement, such as tinnitus, hearing disturbance, geniculate neuralgia, facial twitching. To analyze DPV, the authors reviewed patients with DPV who underwent microvascular decompression (MVD) in our institution. SUBJECTS AND METHOD: A retrospective study was performed on 11 patients with DPV who underwent MVD from January 2002 to September 2007. Information was collected on sex, age, symptoms, offending vessels, the success rate, surgical complications. RESULTS: Three patients were male and eight were female. Their mean age was 55.1 years (range 37-70). The most common offending vessel was AICA in 7 cases (64%) and second vessel was PICA in 3 cases (27%). Only one case (9%) had a vein. Patterns of improvement after MVD could be divided into 3 clinical types. There was complete recovery after operation in 8 cases, partial recovery in 2 cases, and recovery failure in 1 case. There were no major complications except hearing impairment in 1 case. CONCLUSION: This study shows that MVD provides a high rate of success with low morbidity, and can be regarded as one effective procedure for DPV.