Inner ear manipulation to preserve hearing in otologic and neurotologic surgery

Surgical injury of the labyrinth had been generally believed to result in complete hearing loss. However, recent clinical experiences and experimental animal studies allowed surgical access to the inner ear with preservation of the cochlear function, thus providing a new gateway for the treatment of Meniere's disease, benign paroxysmal positional vertigo and cholesteatoma, skull base tumors and acoustic neuromas. Electrophysiological experiments have shown that hearing can be preserved after semicircular canal transection, whereas wide opening of the vestibule results in hearing loss. Our clinical experiences of partial labyrinthectomy for various middle ear diseases, including labyrinthine fistula, petrous bone cholesteatomas and superior semicircular canal dehiscence syndrome are herein presented and pertinent electrophysiological research from our department is also presented and discussed.