# The Surgical Management of Intractable Vertigo and Tinnitus Caused by Neurovascular Compression of the Auditory Vestibular Nerve: A Report of Two Cases and Review of the Literature

## TL;DR

This paper discusses using surgery to treat severe dizziness and tinnitus caused by nerve compression, based on two patient cases and a literature review.

## Contribution

The paper presents two successful surgical cases and suggests microvascular decompression as a treatment option for patients with specific symptoms and radiological evidence.

## Key findings

- Microvascular decompression (MVD) resulted in favorable outcomes for patients with neurovascular compression of the auditory vestibular nerve.
- MVD is suggested as an effective treatment for patients showing a positive response to carbamazepine and clear radiological evidence of nerve compression.
- The paper supports MVD as a treatment option for intractable vertigo and tinnitus associated with neurovascular compression.

## Abstract

Neurovascular compression (NVC) of the auditory vestibular nerve (AVN) may be one of the causes of intractable dizziness and characteristic tinnitus, which are often described as typewriter-like tinnitus. While these symptoms can be alleviated by oral administration of carbamazepine (CBZ), no standard diagnostic and surgical indications and treatment methods have been established. Microvascular decompression (MVD) is effective for these disorders. We describe two cases where MVD resulted in favorable clinical outcomes, and we also review the relevant literature. Our experience suggests that MVD may be an effective treatment option for patients who exhibit a positive response to CBZ, show clear radiological evidence of NVC, and present with both tinnitus and vertigo.