The surgical removal of the labyrinth of the ear.  Labyrinthectomy is a surgical procedure for the management of poorly compensated unilateral peripheral vestibular dysfunction in the presence of a nonserviceable hearing ear. Relief from vertigo is achieved at the expense of the residual hearing in the ear to be operated. Hence, the procedure is reserved for patients with nonserviceable hearing.  The basic principle of labyrinthectomy is to symmetrically open all the semicircular canals and vestibules; the landmarks should be preserved until the end of labyrinthectomy. After exposing all the ampullae and vestibules, the five individual groups of neurosensory epithelia are excised under direct visualization. This is performed to eliminate abnormal vestibular input from the diseased ear.  The osseus labyrinth consists of the cochlea, vestibule, and semicircular canals. The bony cavities are lined with periosteum and contain perilymph. The fenestra vestibuli is an opening in the lateral wall of the vestibule of the osseous labyrinth. It articulates with the footplate of the stapes from the middle ear and opens into the fluid-filled inner ear.

There is transcanal labyrinthectomy and transmastoid labyrinthectomy.

Indications for the transmastoid approach is needed include:

  • Delayed onset of vertigo syndrome
  • Posttraumatic vestibular dysfunction
  • Unilateral Meniere disease
  • Transcanal labyrinthectomy failures

Labyrinthectomy is contraindicated when the affected ear is the only hearing ear. In patients with serviceable hearing, chemical labyrinthectomy or vestibular nerve sectioning will be considered.

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