The dura mater and the mastoid or craniotomy are then closed with a variety of materials, and the patient is observed in the intensive care unit. Because the balance fibers are cut suddenly, the surgery causes intense vertigo and imbalance for a few days requiring supportive medical care, medications for nausea and eventually physical therapy. A cane or walker may be needed for a while, depending on the patient’s health and activity level prior to the surgery. Once the patient is able to ambulate safely, he may be discharged home, but vestibular and balance therapy is continued on an out-patient basis to speed the patient’s recovery as much as possible. A return to full function occurs in most patients, although many do feel imbalanced when tired or stressed.
Managing an acute attack involves preparation. This includes consulting with a physician about any appropriate drugs that can be taken when an acute attack occurs, and deciding ahead of time when it is appropriate to go to a hospital. During an attack, it is helpful to lie down in a safe place with a firm surface, and avoid any head movement. Sometimes keeping the eyes open and fixed on a stationary object about 18 inches away is helpful. In order to control dehydration, a doctor should be called if fluid intake is not possible over time due to persistent vomiting.
The remaining two procedures, vetibular neurectomy and labyrinthectomy, are ways of eliminating the balance function of the faulty ear. It is known that individuals will function better with one normal balance system than with one normal and one faulty system. The labyrinthectomy is a procedure in which the mastoid bone is removed and the inner ear is eliminated. This procedure is for patients that have lost usable hearing in the affected ear, as it entails removing all function of the inner ear, including hearing and balance. The change from having two balance systems to having one balance system alone does require a recovery or "compensation" period. It takes the brain a period of weeks to figure out that only one system is active and that it is no longer receiving information from the faulty system which it had come to expect. The second procedure, the vestibular neurectomy, is a good option if the hearing is good in the ear with the failing balance system. In this surgical procedure, the balance nerve (vestibular nerve) is cut between the inner ear and the brain. The inner ear is completely preserved but the faulty balance information is not able to reach the brain and cause the vertigo. Like the labyrinthectomy, this procedure requires a recovery period while the brain "figures out" the new situation.