Commentary “Transmastoid Partial Labyrinthectomy for Brainstem Vascular Lesions: Clinical Outcomes and Assessment of Postoperative Cochleovestibular Function”

The authors described their experience with nine patients who underwent a transmastoid partial labyrinthectomy for brainstem vascular lesions. Previously, this procedure has been reported to preserve serviceable hearing in most patients. In my opinion, the real contribution of this article is the postoperative vestibular testing. An increase in caloric reduction was noted in seven of eight patients. Postoperative vestibular evoked myogenic potentials were also recorded, and no response was noted in four of seven patients. No pre- or postoperative response was recorded from one patient while potentials were recorded from two patients. The vestibular ocular reflex (VOR) showed normal gain, and its functionality was preserved.

This article can be added to the armamentarium of literature that justifies the safety and efficacy of this operation to access regions of the petrous apex, clivus, brainstem, and cerebellopontine angle.