Alternative Surgeries for Vertigo in Meniere's Disease

1995 ◽  
Vol 112 (5) ◽  
pp. P44-P44
Author(s):  
Dirk Hoehmann ◽  
John L. Dornhoffer
Keyword(s):  
Medical Treatment ◽  
Surgical Procedures ◽  
Meniere’S Disease ◽  
Vestibular Nerve ◽  
Menière’S Disease ◽  
Endolymphatic Sac ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Ménière's Disease

Educational objectives: To find a straightforward strategy in dealing with vertigo in patients with Meniere's disease who failed medical treatment, and to be familiar with fine points of surgical procedures, including endolymphatic sac surgery, cochleostomy, vestibular nerve sections, and labyrinthectomy.

scholarly journals Endolymphatic Sac Surgery for Ménière's Disease – Current Opinion and Literature Review

2017 ◽  
Vol 21 (02) ◽  
pp. 179-183 ◽  
Author(s):  
Maria Flores García ◽  
Carolina Llata Segura ◽  
Juan Cisneros Lesser ◽  
Carlo Pane Pianese
Keyword(s):  
Surgical Procedures ◽  
Endolymphatic Hydrops ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Endolymphatic Sac ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Complication Rates ◽  
Menière's Disease ◽  
Ménière's Disease

Introduction The endolymphatic sac is thought to maintain the hydrostatic pressure and endolymph homeostasis for the inner ear, and its dysfunction may contribute to the pathophysiology of Ménière's disease. Throughout the years, different surgical procedures for intractable vertigo secondary to Ménière's disease have been described, and though many authors consider these procedures as effective, there are some who question its long-term efficacy and even those who think that vertigo control is achieved more due to a placebo effect than because of the procedure itself. Objective To review the different surgical procedures performed in the endolymphatic sac for the treatment of Ménière's disease. Data Sources PubMed, MD consult and Ovid-SP databases. Data Synthesis We focus on describing the different surgical procedures performed in the endolymphatic sac, such as endolymphatic sac decompression, endolymphatic sac enhancement, endolymphatic sac shunting and endolymphatic duct blockage, their pitfalls and advantages, their results in vertigo control and the complication rates. The senior author also describes his experience after 30 years of performing endolymphatic sac surgery. Conclusions The endolymphatic sac surgery, with all its variants, is a good option for patients with incapacitating endolymphatic hydrops, providing a high percentage of vertigo control and hearing preservation.

Results of Surgical Treatment for Menière's Disease

1989 ◽  
Vol 100 (3) ◽  
pp. 195-199 ◽  
Author(s):  
Richard P. Jennings ◽  
Carl L. Reams ◽  
John Jacobson ◽  
James M. Cole
Keyword(s):  
Hearing Loss ◽  
Surgical Procedures ◽  
Meniere’S Disease ◽  
Vestibular Nerve ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Nerve Section ◽  
Ménière's Disease

In 1985 the American Academy of Otolaryngology—Head and Neck Surgery Committee on Hearing and Equilibrium established revised guidelines for reporting treatment results for Menière's disease. Since then little Information regarding the newly adapted criteria and their effects on the evaluation process has appeared. Thus we compared the results of different surgical procedures for Menière's disease using both the 1985 and 1972 guidelines. One hundred nine surgical procedures from 1969 to 1985 were reviewed. Six different surgical procedures were evaluated: The Cody-Tack, cochleosacculotomy, endolymphatic mastoid shunt, endolymphatic subarachnoid shunt, translabyrinthine vestibular nerve section, and transcanal labyrinthectomy. Results show that 68% of patients who had a Cody-Tack procedure continued to have vertiginous episodes in the same freguency postoperatively. Hearing was worse in 17 of these 25 patients. Of the patients who had a eochleosacculotomy, most had significant control of their vertiginous symptoms, but 10 patients had greater than 10 dB hearing loss postoperatively. Patients who had an endolymphatic mastoid shunt performed had better results when the 1972 guldllnes were applied. In this group, the 1985 guidelines indicate that only 35% of the patients had significant relief of their vertiginous symptoms and 47% had hearing loss greater than 10 dB postoperatively. Six of the seven patients who underwent an endolymphatic subarachnoid shunt obtained significant relief of their vertiginous episodes, but hearing loss was more than 10 dB In four patients. Those patients who had either a labyrinthectomy or a translabyrinthine vestibular nerve section had relief of their vertiginous episodes. We conclude that the new guidelines appear to be superior to the 1972 guidelines for reporting results for the treatment of Menière's disease.

Experimental Study on Meniere's Disease

1982 ◽  
Vol 90 (4) ◽  
pp. 470-481 ◽  
Author(s):  
Masaaki Kitahara ◽  
Taizo Takeda ◽  
Yoshiro Yazawa ◽  
Hideharu Matsubara ◽  
Hitoshi Kitano
Keyword(s):  
Experimental Study ◽  
Stria Vascularis ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Endolymphatic Sac ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Ménière's Disease

Experimental hydrops caused by underabsorption of endolymphatic fluid is a model of remissional stage of Meniere's disease. In this study, another type of model, ie, hydrops caused by overproduction of endolymphatic fluid, was accomplished by applying various pressures into scala media through a micropipette via stria vascularis. This type of hydrops could be a model of attacks of Meniere's disease. By using two types of the model, effects of glycerol administration and of opening the endolymphatic sac were discussed.

The Role of Vestibular Nerve Section in Meniere's Disease

1997 ◽  
Vol 76 (9) ◽  
pp. 652-663 ◽  
Author(s):  
Gerald B. Brookes
Keyword(s):  
Primary Care Physicians ◽  
Meniere’S Disease ◽  
Vestibular Nerve ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Nerve Section ◽  
Ménière's Disease

The role of vestibular nerve section (VNS) surgery in the management of Meniere's disease is considered by prospective analysis of a large series of 531 patients treated by the author over a period of 11 years. Twenty-seven percent were referred by their primary care physicians, while the rest were secondary (45.6%) or tertiary (27.3%) referrals. Overall, 62 (11.7%) Meniere's patients underwent 63 VNS procedures. This surgery was undertaken more frequently in the secondary and tertiary referral patients (14.2%) than in the primary referrals (5.5%). The retrolabyrinthine technique was the preferred approach in almost 90% of ears. The results and complications of these and other surgical options are discussed in an attempt to define the present role of VNS in intractable Meniere's disease. Vertigo was abolished after VNS in 93% of cases. Compensation was significantly impaired in 12.9%. All these patients had contralateral Meniere's disease or marked labyrinthine hypofunction. Although highly effective and associated with few postoperative complications, VNS is generally reserved for sac failures, though may be appropriate as a primary procedure in severe unilateral cases.

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