Although there are many types of vertigo, the most common are those caused by the ear and, in particular, Ménière’s disease. Symptoms are rotatory vertigo crises, sometimes with nausea or vomiting. Also tinnitus (ear noises) and hearing loss which is often fluctuating. The crises can be very violent and totally disabling for the patient.
The first treatment should be medical, indicated by the specialist, but there are many patients who do not achieve sufficient improvement, so other therapeutic actions such as surgery must be chosen.
The injection of drugs such as gentamicin or cortisone in the ear can improve symptoms in some cases, but they hardly achieve a complete elimination of dizziness, as well as the intervention called “decompression of the endolymphatic sac”. But there are two types of surgery with which the elimination of vertigo is achieved.
The first one is the “vestibular neurectomy” and is based on the section of the vestibular nerve. Its effectiveness is 99% although there is a small risk of hearing loss. It is performed in healthy people under 60-65 years of age, with impaired but still useful hearing.
On the other hand, people of any age with disabling vertigo and significant deafness may opt for the destruction of the labyrinth (labyrinthectomy), although this entails the loss of hearing in the diseased ear.
After a period of postoperative instability (not vertigo), the patient recovers free of vertiginous crises.
There are thousands of patients who have eliminated their vertigo thanks to surgery.
Deafness due to otosclerosis
There are many types of deafness, but one of the most common is otosclerosis, which causes progressive deafness.
It consists of an ossification of the stapes, the smallest ossicle of the stapes. It has a higher incidence in adulthood and is more frequent in women, and is accentuated by pregnancy.
The evolution is always towards hearing deterioration and there are no effective medical treatments except surgery.
Generally, deafness is accompanied by tinnitus (ear noises) and occasionally by instability, which is usually slight.
Hearing loss can be corrected with a hearing aid, but the progression of the disease will make it necessary to change the hearing aid as hearing worsens.
The ideal solution for otosclerosis deafness is surgery, which in expert hands is close to 99% effective.
The operation is performed by microsurgery with the help of laser. It can be performed under local anesthesia and usually lasts about 15-20 minutes.
The technique is called stapedectomy / stapedotomy, i.e. the total or partial removal of the stapes and replacement with a prosthesis (there are several types and materials) usually with a graft, which replaces the anatomy and functionality of hearing.
Although it is a delicate operation, it is at the same time very atraumatic for the patient, since he/she can be discharged a few hours after the operation or with only one night of hospitalization, depending on the technique used.
The García-Ibáñez Institute has one of the largest experiences in Europe in this surgery.