A labyrinthectomy is a surgery to remove the labyrinth in the ear. The labyrinth is a structure that usually helps with balance. A doctor may recommend a labyrinthectomy if an issue with the labyrinth is causing balance problems.

The inner ear plays an important role in balance. It contains the vestibular system, a sensory system that provides the brain with information about motion, positioning, and spatial orientation.

The vestibular system contains a structure called the labyrinth. People who have problems with the labyrinth may experience balance issues. If other treatment options cannot resolve these problems, a doctor may recommend a labyrinthectomy, which is surgery to remove the labyrinth.

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A labyrinthectomy is a surgical procedure that involves removing a part of the inner ear called the labyrinth.

This part of the ear consists of bony structures, known as the bony labyrinth, and soft tissues, known as the membranous labyrinth, that play an important role in hearing and balance.

Doctors may refer to a labyrinthectomy as a type of destructive surgery. This means that the procedure aims to stop the production of sensory information or prevent its transmission from the inner ear to the brain.

A doctor may recommend a labyrinthectomy if a person is experiencing a long-term vestibular condition that is not responding to nonsurgical treatments.

Vestibular conditions refer to those that impact the vestibular system. This system comprises parts of the inner ear that process sensory information that helps with balance.

One of the more common reasons a person may need a labyrinthectomy is to treat Ménière’s disease. This is a condition that can result in:

However, as the procedure will result in deafness, a doctor may not offer a labyrinthectomy if a person still has good hearing in the affected ear, particularly if it is the only hearing ear.

Generally, a person will not need to prepare anything before the procedure.

However, a doctor may request that they stop taking certain medications and cease smoking, if applicable. Additionally, a person should be aware that they will receive general anesthesia before the procedure and may need to remain in the hospital for up to 3 days afterward.

Before the procedure, the surgeon may need to remove any hair from around the ear. They may also place facial nerve monitors to help them identify and minimize facial nerve injury.

A surgeon will perform the labyrinthectomy procedure under general anesthesia. It may take up to 2 hours.

The goal of a labyrinthectomy is to remove the labyrinth portion of the inner ear. Typically, this will involve using a drilling tool and other instruments to remove these structures.

Usually, a surgeon performs a labyrinthectomy through a transcanal or transmastoid approach.

The transcanal approach, which goes through the ear canal, is less invasive and quicker, but there is a higher risk of incomplete removal of the labyrinth. It involves making an opening in the eardrum to access the labyrinth and remove it with a hook and suction.

Surgeons often consider the transmastoid approach the gold standard for labyrinthectomy. This involves going through the mastoid bone behind the ear.

After a labyrinthectomy procedure, a person may spend 2–3 days in hospital.

They will have an incision behind or above their ear and dressing over their ear and head. Their care team will typically remove the bandages after a couple of days.

When leaving the hospital, the care team will provide medications and instructions to help aid recovery. For example, this may include balance exercises to help a person adapt to the changes they may experience.

Medications may include:

The incision around the ear will consist of stitches under the skin that dissolve and will not require removal. Typically, Steri-Strips will cover the incision and remain in place for roughly 2 weeks. After removing the strips, a person should gently clean the incision with peroxide once or twice daily. They can also apply a thin layer of antibiotic ointment.

A person should be able to wash their hair 3 days after surgery. However, they will need to try to prevent getting this area wet. Additionally, it is not advisable to blow the nose for 4 weeks after surgery. People will also need to avoid vigorous physical activity for at least 3 weeks and avoid flying for up to 6 weeks.

Usually, a person will have a follow-up visit 2–3 weeks after the procedure to ensure everything is healing correctly.

During the recovery period, a person may also notice changes such as:

Evidence indicates that labyrinthectomy is a highly effective treatment for disabling vertigo. As such, it is a useful option for treating symptoms of vestibular conditions when medical and conservative options are ineffective.

While a labyrinthectomy procedure focuses on removing the portion of the inner ear that controls balance, it will also destroy the part of the ear responsible for hearing.

A person must consider that destruction of the hearing function will result in complete hearing loss in the affected ear.

Other possible complications of a labyrinthectomy may include:

A labyrinthectomy is a surgical procedure to remove the labyrinth in the ear. This is part of the inner ear that helps with balance. A doctor may recommend this surgery if a person has balance problems that do not improve with medications.

Labyrinthectomy effectively treats certain balance problems, such as Ménière’s disease. However, it will result in hearing loss in the affected ear.