The hearing and balance nerves travel together in the space between the brain and skull. They can be affected by compressive blood vessels which can result in balance disorders, hearing loss or tinnitus (ringing in the ears). Blood vessel compression of the balance nerves results in a syndrome where the patient has actual spinning or feeling of disequilibrium. It is often accompanied by nausea and occasionally vomiting and is generally worsened by motion.

Medications such as Valium or Klonipin may help. Should they not help, vestibulat testing can determine which balance nerve is affected. In this case, if other causes are not identified, microvascular decompression (MVD) can be performed and may help.

With the collaboration of out ENT colleagues we are learning more about which patients are good candidates for MVD in the management of vertigo and tinnitus.

Currently all our patients are initially assessed by neuro-otologist prior to being seen by a neurosurgeon. Patients are selected for surgery based upon a joint discussion and undergo collaborative surgery. We have previously reported varying degrees of success with MVD and soon hope to be able to identify the subset of patients that most likely respond to such surgical intervention.

(A) Vein decompressed off cranial nerve eight using
Teflon felt; (B) artery decompressed off cranial nerve
eight using Teflon felt.