MRI of the vestibular nerve after selective vestibular neurectomy

Swee T. Aw, John S. Magnussen, Michael J. Todd, Sam McCormack, G. Michael Halmagyi

Research output: Contribution to journalArticleResearchpeer-review

Abstract

Conclusion. In patients with Ménière's disease and persisting vertigo attacks after vestibular neurectomy (VNx) MRI of the vestibulocochlear nerve can identify residual vestibular nerve fibres that could be responsible for the vertigo attacks. Objective. To test if MRI of the vestibulocochlear nerve can corroborate the presence of residual vestibular nerve fibres in patients with persisting vertigo attacks and residual vestibular function after VNx. Materials and methods. Vestibulocochlear nerve bundles of seven post-VNx unilateral Ménière's patients were imaged using 1.5 Tesla MRI with steady state free precession (SSFP) sequences. Reformatted MR images orthogonal to the vestibulocochlear nerve axis in internal auditory canal were compared on the VNx and intact sides. Vestibular function was assessed with caloric tests, three-dimensional head impulse tests and vestibular evoked myogenic potentials. Of the seven patients only one was asymptomatic (totally free of vertigo); six had continued to experience vertigo attacks, albeit not as long or as severe as before VNx. Results. On the VNx side, MRI showed intact facial and cochlear nerves in all seven patients. In the six symptomatic patients, although superior and inferior vestibular nerve bulk and signal were reduced, residual bulk suggestive of inferior vestibular nerve was evident, correlating with evidence of residual posterior canal function on impulsive testing in all six symptomatic patients. In the asymptomatic patient, superior and inferior vestibular nerves were absent on MRI and impulsive testing revealed no residual posterior canal function.

LanguageEnglish
Pages1053-1056
Number of pages4
JournalActa Oto-Laryngologica
Volume126
Issue number10
DOIs
Publication statusPublished - 1 Oct 2006
Externally publishedYes

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Vestibular Nerve
Vestibulocochlear Nerve
Vertigo
Nerve Fibers
Head Impulse Test
Vestibular Evoked Myogenic Potentials
Caloric Tests
Cochlear Nerve
Meniere Disease
Facial Nerve
Magnetic Resonance Imaging

Cite this

Aw, Swee T. ; Magnussen, John S. ; Todd, Michael J. ; McCormack, Sam ; Halmagyi, G. Michael. / MRI of the vestibular nerve after selective vestibular neurectomy. In: Acta Oto-Laryngologica. 2006 ; Vol. 126, No. 10. pp. 1053-1056.
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MRI of the vestibular nerve after selective vestibular neurectomy. / Aw, Swee T.; Magnussen, John S.; Todd, Michael J.; McCormack, Sam; Halmagyi, G. Michael.

In: Acta Oto-Laryngologica, Vol. 126, No. 10, 01.10.2006, p. 1053-1056.

Research output: Contribution to journalArticleResearchpeer-review

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N2 - Conclusion. In patients with Ménière's disease and persisting vertigo attacks after vestibular neurectomy (VNx) MRI of the vestibulocochlear nerve can identify residual vestibular nerve fibres that could be responsible for the vertigo attacks. Objective. To test if MRI of the vestibulocochlear nerve can corroborate the presence of residual vestibular nerve fibres in patients with persisting vertigo attacks and residual vestibular function after VNx. Materials and methods. Vestibulocochlear nerve bundles of seven post-VNx unilateral Ménière's patients were imaged using 1.5 Tesla MRI with steady state free precession (SSFP) sequences. Reformatted MR images orthogonal to the vestibulocochlear nerve axis in internal auditory canal were compared on the VNx and intact sides. Vestibular function was assessed with caloric tests, three-dimensional head impulse tests and vestibular evoked myogenic potentials. Of the seven patients only one was asymptomatic (totally free of vertigo); six had continued to experience vertigo attacks, albeit not as long or as severe as before VNx. Results. On the VNx side, MRI showed intact facial and cochlear nerves in all seven patients. In the six symptomatic patients, although superior and inferior vestibular nerve bulk and signal were reduced, residual bulk suggestive of inferior vestibular nerve was evident, correlating with evidence of residual posterior canal function on impulsive testing in all six symptomatic patients. In the asymptomatic patient, superior and inferior vestibular nerves were absent on MRI and impulsive testing revealed no residual posterior canal function.

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