Herniation of the Membranous Labyrinth Into the Horizontal Semicircular Canal Is Correlated With Impaired Caloric Response in Ménière’s Disease

Objective: To investigate the symptomatic relief and functional preservation of a novel surgical strategy combined with triple semicircular canal occlusion and endolymphatic sac decompression in patients with intractable Meniere’s disease. Design: Retrospective analysis. Setting: Patients with intractable Meniere’s disease in the Department of Otolaryngology Head & Neck in the Second Affiliated Hospital of Nanchang University between July 2015 and June 2019. Participants: Data from 46 patients diagnosed with Meniere’s disease, and underwent surgery Methods: Triple semicircular canal occlusion combined with endolymphatic sac decompression was performed in all patients with intractable Meniere’s disease. Pre- and postoperative vertigo attacks, hearing levels, tinnitus, aural fullness, and equilibrium function rehabilitation were analyzed at defined time points during follow-up. Results: A significant vertigo control rate was observed in all patients postoperatively. The overall control rate of vertigo postoperatively was 100% in the entire follow-up, with a complete control rate of 97.8% and a substantial control rate of 2.2%. The rate of hearing preservation was 54.35%, and all patients suffering from hearing deterioration were at stages III and IV. The rate of tinnitus and aural fullness alleviation was 65.8% and 100%, respectively. Four patients failed to regain the equilibrium function postoperatively. Conclusion: Combining triple semicircular canal occlusion with endolymphatic sac decompression is an efficient strategy for vertigo control in patients with intractable Meniere’s disease. Patients in advanced stages suffered more from hearing function deterioration. Hearing preservation and tinnitus alleviation warrant further investigation.

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Superior Semicircular Canal Dehiscence Syndrome Manifested as Menière’s Disease: A Case Report

Research in Vestibular Science ◽

10.21790/rvs.2021.20.3.108 ◽

2021 ◽

Vol 20 (3) ◽

pp. 108-112

Author(s):

Byeong Jin Kim ◽

Yun Na Yang ◽

Chan Mi Lee ◽

Eun Jung Lee

Keyword(s):

Semicircular Canal ◽

Meniere’S Disease ◽

Menière’S Disease ◽

Meniere's Disease ◽

Ménière’S Disease ◽

Menière's Disease ◽

Superior Semicircular Canal Dehiscence ◽

Superior Semicircular Canal ◽

Ménière's Disease ◽

Canal Dehiscence

The absence of a temporal bone overlying the superior semicircular canal causes superior semicircular canal dehiscence (SSCD). The vestibular symptom of SSCD syndrome (SCDS) is vertigo and audiologic symptoms include autophony, hyperacusis, and ear fullness. A 52-year-old man presented with left-sided unilateral hearing loss, aural fullness, and recurrent spinning-type vertigo. He had positive Hennebert sign and mixed-type hearing loss, with a prominent low-frequency air-bone gap. These symptoms reminded us of SCDS, and computed tomography (CT) revealed SSCD. However, the patient had not experienced vertigo until 1 week prior to the visit. In addition, the audiogram revealed fluctuation of hearing, which was aggravated when the vestibular symptoms manifested. Vertigo might be due to Menière’s disease rather than SCDS and SSCD was incidentally detected on CT. According to reviews, this is no reported case of SCDS manifested as Menière’s disease, so we report this case with a brief review of the literature.

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State of the Art Imaging in Menière’s Disease. Tips and Tricks for Protocol and Interpretation

Current Radiology Reports ◽

10.1007/s40134-020-00365-z ◽

2020 ◽

Vol 8 (11) ◽

Author(s):

Lisa M. H. de Pont ◽

Josephine M. van Steekelenburg ◽

Berit M. Verbist ◽

Mark A. van Buchem ◽

Henk M. Blom ◽

...

Keyword(s):

Meniere’S Disease ◽

Menière’S Disease ◽

Meniere's Disease ◽

Ménière’S Disease ◽

Imaging Features ◽

Menière's Disease ◽

Membranous Labyrinth ◽

Reliable Technique ◽

Ménière's Disease

Abstract Purpose of Review Menière’s disease (MD) is a burdensome and not well understood inner ear disorder that has received increasing attention of scientists over the past decade. Until 2007, a certain diagnosis of endolymphatic hydrops (EH) required post-mortem histology. Today, dedicated high-resolution magnetic resonance imaging (MRI) protocols enable detection of disease-related changes in the membranous labyrinth in vivo. In this review, we summarize the current status of MR imaging for MD. Recent Findings The mainstays of hydrops imaging are inversion recovery sequences using delayed acquisition after intravenous or intratympanic contrast administration. Based on these techniques, several methods have been developed to detect and classify EH. In addition, novel imaging features of MD, such as blood-labyrinth barrier impairment, have recently been observed. Summary Delayed contrast enhanced MRI has emerged as a reliable technique to demonstrate EH in vivo, with promising application in the diagnosis and follow-up of MD patients. Therefore, familiarity with current techniques and diagnostic imaging criteria is increasingly important.

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Electron microscopic observations on the human membranous labyrinth with particular reference to Ménière's disease

Journal of Ultrastructure Research ◽

10.1016/s0022-5320(63)80040-4 ◽

1963 ◽

Vol 9 (1-2) ◽

pp. 123-138 ◽

Cited By ~ 50

Author(s):

I. Friedmann ◽

T. Cawthorne ◽

K. McLay ◽

E.S. Bird

Keyword(s):

Meniere’S Disease ◽

Menière’S Disease ◽

Meniere's Disease ◽

Ménière’S Disease ◽

Menière's Disease ◽

Electron Microscopic ◽

Membranous Labyrinth ◽

Ménière's Disease

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Endolymphatic Sac Surgery And Posterior Semicircular Canal Fenestration For Meniere’s Disease

PRILOZI ◽

10.2478/prilozi-2021-0012 ◽

2021 ◽

Vol 42 (1) ◽

pp. 141-148

Author(s):

Ilija S. Filipche ◽

Marina Davcheva Chakar ◽

Venko Filipche ◽

Sijavash Javari

Keyword(s):

Semicircular Canal ◽

Vestibular Function ◽

Meniere’S Disease ◽

Menière’S Disease ◽

Endolymphatic Sac ◽

Meniere's Disease ◽

Ménière’S Disease ◽

Menière's Disease ◽

Posterior Semicircular Canal ◽

Ménière's Disease

Abstract Objective: To evaluate the efficiency and safety of the simultaneous endolymphatic sac drainage (ELSD) and posterior semicircular canal fenestration (PSCF) primary on the vestibular function as an new therapeutic strategy in the patients with medically refractory Meniere’s disease (MD). Study Design: retrospective follow-up study. Setting: University Clinic of Otolaryngology. Methods: Twenty-six patients with MD with severe vertigo and disability who underwent ELSD and PSCF in the same time in the period of 1988 and 2007 were reviewed. The main outcome measures were frequency of vertigo, functional disability according the guidelines for diagnosis and evaluation of therapy in MD. The canal paresis was evaluated by caloric test. The degree of reduced vestibular response rates as an indicators of the vestibular function were compared before and after surgery. Results: The preoperative audition was already altered in all cases except in 8 patients who had no significant changes in hearing threshold. The mean value of vertigo attacks before operation was 8.6. After 3 years of surgery only one patient (3.8%) had one vertigo attack. Functional level was highly ameliorated except in two patients who presented functional level 2 or B in the late postoperative period. The mean caloric testing duration after 3 years postoperatively showed that the 50% of the patients approaching the normal results. Conclusion: Based on the results of simultaneous endolymphatic sac surgery and posterior canal fenestration, they are effective methods for treatment of the refractory Meniere’s disease. Endolymphatic sac surgery enables drainage of endolymphatic fluid and the fenestration of the posterior semicircular canal enables the distension or dilatation of the membranous canal in the decompressed perilymphatic space across the perilymphatic leak at the level of the new fenestra, and, so, appearing of certain decrease of the endolymphatic pressure. Both techniques at the same time decrease the pressure in the case of the endolymphatic hydrops.

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