For the majority of underlying causes of vertigo, the mainstay of treatment is medical therapy. Surgery is usually reserved for patients with either tumor associated vertigo, cholesteatoma, and/or when it does not respond to multiple medical therapies.

• Surgery is not the first-line treatment option for patients withvertigo. Surgery is usually reserved for patients with:
  • Ménière’s disease: Decompress endolymphatic sac, labyrinthectomy, Vestibular nerve section^[1].
  • Acoustic neuroma: For large, symptomatic, growing tumor one of the following treatment is helpful after weighing risks and benefits: Radiotherapy, radiosurgery or surgical removal.
  • Benign paroxysmal positional vertigo: For resistant and severe cases occlusion of semi-circular canal may be helpful.
  • Cholesteatoma: Surgical removal followed by periodic follow-ups.
  • Otosclerosis: Surgical procedure of choice is stapedectomy.^[2]
  • Cerebellopontine angle tumors: Observation, radiotherapy, or microsurgery is selected as a plan of treatment after assessing the size/growth of the tumor, age of the patient, and comorbidities.^[3]