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Microvascular Decompression Surgery for Disabling Positional Vertigo and Tinnitus

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Microvascular Decompression Surgery

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Abstract

Disabling positional vertigo (DPV) and some forms of tinnitus can be treated successfully with microvascular decompression (MVD) of the root of the auditory-vestibular nerve. These two diseases have many different forms and the operation is more complex than MVD for trigeminal neuralgia or hemifacial spasm. Success of DPV depends on correct selection of candidates for the treatments. In a study of 41 patients operated upon for severe DPV, 73.2 % were totally free of DPV symptoms or experienced significant improvements that allowed them to return to nearly normal life, 4.9 % had minor relief of symptoms, and 22 % had no noticeable improvement. Other studies have shown that treatment with medications of the benzodiazepine family such as Valium is effective in some individuals who have DPV symptoms.

 In a study of 72 patients who underwent MVD operations for severe tinnitus, 18.1 % had total relief from tinnitus, 22.2 % had marked improvement, 11.1 % slight improvement, 45.8 % no improvement, and 2.8 % experienced a worsening of symptoms.

 The success of MVD operations as treatment of severe tinnitus was inversely related to the time the patients had had their tinnitus. Those who experienced total relief or marked improvement had had their tinnitus for an average of 2.9 and 2.7 years, respectively; those who showed slight or no improvement had prior experienced with tinnitus for 5.2 and 7.9 years, respectively.

 There was a strong gender effect; of the 32 women in the study, 54.8 % experienced total relief or marked improvement, while of the 40 men, only 29.3 % had favorable outcome.

 Studies have shown that administration of benzodiazepines such as alprazolam can have beneficial effect on some forms of tinnitus.

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Authors and Affiliations

  1. Distinguished Lecturer in Behavioral and Brain Sciences, Professor of Cognition and Neuroscience, Founders Professor, School of Behavioral and Brain Sciences, The University of Texas, Dallas, GR 41, TX, USA

    Aage R. Møller PhD, DMedSci

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  1. Aage R. Møller PhD, DMedSci
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Editors and Affiliations

  1. Shanghai, China

    Shi-Ting Li

  2. Dept. Neurosurgery, XinHua Hospital, Shanghai, China

    Jun Zhong

  3. UPMC Presbyterian Hospital, Pittsburgh, Pennsylvania, USA

    Raymond F. Sekula, Jr.

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Møller, A.R. (2016). Microvascular Decompression Surgery for Disabling Positional Vertigo and Tinnitus. In: Li, ST., Zhong, J., Sekula, Jr., R. (eds) Microvascular Decompression Surgery. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-7366-9_8

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  • DOI: https://doi.org/10.1007/978-94-017-7366-9_8

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