scholarly journals A comparison of endolymphatic duct blockage, endolymphatic sac drainage and endolymphatic sac decompression surgery in reversing endolymphatic hydrops in Meniere’s disease

2021 ◽  
Vol 50 (1) ◽  
Author(s):  
Anquan Peng ◽  
Junjiao Hu ◽  
Qin Wang ◽  
Xueying Pan ◽  
Zhiwen Zhang ◽  
...  
Keyword(s):  
Endolymphatic Hydrops ◽  
Meniere’S Disease ◽  
Endolymphatic Sac ◽  
Decompression Surgery ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Complete Control ◽  
The Third ◽  
Endolymphatic Duct ◽  
Ménière's Disease

Abstract Background To explore the differences between endolymphatic duct blockage, endolymphatic sac drainage and endolymphatic sac decompression surgery in the reversal of endolymphatic hydrops (EH) in patients with intractable Meniere’s disease (MD). Methods A total of 27 MD patients receiving endolymphatic duct blockage surgery (n = 10), endolymphatic sac drainage surgery (n = 9) and endolymphatic sac decompression surgery (n = 8) underwent gadolinium-enhanced inner ear magnetic resonance imaging (MRI) scans prior to, 2 weeks after and at > 12 months following surgery. Results In the group with endolymphatic duct blockage, the second MRI revealed no changes in EH, whereas the third MRI revealed a reversal of vestibular EH in 3 patients and a downgrading of cochlear hydrops in 2 of these 3 patients, who presented with an improvement in their hearing and complete control of vertigo. In the group with endolymphatic sac drainage, the second MRI showed a reversal of EH in 4 patients, and no changes in EH in the remaining 5 patients, whereas the third MRI showed that those 4 patients who presented with a reversal of EH at the second MRI stage remained unchanged except a recurrence of vestibular hydrops in 1 patient. All 4 patients exhibited a complete control of vertigo, but hearing improved in 1, worsened in 1 and remained unchanged in 2. In the group with endolymphatic sac decompression, both the second and third MRI examination revealed no reversal of EH. Conclusions The present study has shown that both endolymphatic duct blockage surgery and endolymphatic sac drainage surgery have the potential to reduce EH in certain MD patients, but none of the patients receiving endolymphatic sac decompression surgery showed reversal of their EH. Graphical Abstract

scholarly journals Differences between endolymphatic duct blockage and endolymphatic sac drainage surgery in the reversal of endolymphatic hydrops in patients with Meniere’s disease, preliminary results

2020 ◽  
Author(s):  
Wenqi Jiang ◽  
Junjiao Hu ◽  
Anquan Peng ◽  
Qin Wang ◽  
Xueying Pan ◽  
...  
Keyword(s):  
Endolymphatic Hydrops ◽  
Meniere’S Disease ◽  
Endolymphatic Sac ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Complete Control ◽  
The Third ◽  
Endolymphatic Duct ◽  
Ménière's Disease

Abstract To explore the differences between endolymphatic duct blockage (EDB) and endolymphatic sac drainage (EDD) surgery in the reversal of endolymphatic hydrops (EH) in patients with intractable Meniere’s disease (MD). A total of 19 MD patients receiving EDB (n=10) and EDD (n=9) treatment underwent gadoliniumenhanced inner ear magnetic resonance imaging (MRI) scans prior to, 2 weeks after and at >12 months following surgery. In the EDB group, the second MRI revealed no changes in EH, whereas the third MRI revealed a reversal of vestibular EH in 3 patients and a downgrading of cochlear hydrops in 2 of these 3 patients, who presented with an improvement in their hearing and complete control of vertigo. In the EDD group, the second MRI showed a reversal of EH in 4 patients, and no changes in EH in the remaining 5 patients, whereas the third MRI showed that those 4 patients who presented with a reversal of EH at the second MRI stage remained unchanged, with the exception of one patient who experienced a recurrence of vestibular hydrops. All 4 patients exhibited a complete control of vertigo, although hearing improved in only 1 of them, worsened in 1 and remained unchanged in 2. The present study showed the reversal in EH was likely due to the delayed effect of surgery accompanied by an improvement in hearing in EDB group, whereas the reduction in the endolymph volume presented as an acute reversal of hydrops in EDD group without a causeeffect relationship with hearing function.

scholarly journals Dynamics in Endolymphatic Hydrops & Symptoms in Meniere's Disease After Endolymphatic Duct Blockage, Preliminary Results

2021 ◽  
Vol 11 ◽  
Author(s):  
Jun He ◽  
Anquan Peng ◽  
Junjiao Hu ◽  
Zhiwen Zhang ◽  
Yichao Chen ◽  
...  
Keyword(s):  
Endolymphatic Hydrops ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Complete Control ◽  
Significant Difference ◽  
Endolymphatic Duct ◽  
Ménière's Disease

Objective: The purpose of the present study was to evaluate the dynamics of endolymphatic hydrops (EH) and symptoms in a group of patients who underwent endolymphatic duct blockage (EDB) for treatment of intractable Meniere's Disease (MD), and to explore a metric for verifying the effectiveness of EDB procedure.Methods: A total of 22 patients with intractable MD patients who underwent EDB participated in the present study. EH was visualized using locally enhanced inner ear magnetic resonance imaging (MRI) prior to and following surgery. The vestibular hydrops ratio (VHR) in the second MRI examination was compared with the pre-surgery recordings.Results: Following EDB, 6 patients exhibited complete or partial reversal of EH, complete control of vertigo spells and reported improvement in hearing; 13 patients showed no changes in EH or hearing, but 5 of these patients exhibited complete control of vertigo attacks, and the other 8 patients exhibited improved control of vertigo attacks. The final 3 patients showed an increase in EH, but symptomatic worsening in 2 patients, and symptomatic improvement in 1 patient. There was a significant difference in the average VHR prior to and following EDB. Postoperative VHR was positively correlated with the frequency of vertigo spells in the latest 6 months of follow-up and improvement of postoperative average hearing threshold.Conclusion: The decreased EH accompanying the reduction in vertigo attacks and hearing preservation may provide a metric for verifying the effectiveness of EDB treatment in patients with MD.

Endolymphatic Duct Obstruction from a Jugular Bulb Diverticulum

1981 ◽  
Vol 90 (6) ◽  
pp. 619-623 ◽  
Author(s):  
Robert A. Jahrsdoerfer ◽  
Wayne S. Cail ◽  
Robert W. Cantrell
Keyword(s):  
Endolymphatic Hydrops ◽  
Jugular Bulb ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Radiographic Appearance ◽  
Endolymphatic Duct ◽  
Ménière's Disease

Herniation of the jugular bulb into the middle ear is uncommon. Extension of a jugular bulb diverticulum into the petrous pyramid is rare. In ten previously reported cases in the literature, only the radiographic appearance of the lesion was stressed. Of interest to otolaryngologists is the fact that in seven of the cases there was an ipsilateral sensorineural hearing loss. Other symptoms included tinnitus and vertigo. One patient had been diagnosed as having Menière's disease. We document an additional case (a patient who had “classical Menière's disease”) and report the first known surgical exploration of this venous anomaly. The diverticulum extended high into the petrous bone and was found to obliterate the distal segment of the endolymphatic duct. To our knowledge, this is the first time that a cause and effect relationship has been recognized between endolymphatic hydrops and a jugular bulb diverticulum. We propose that the diverticulum, by obstructing the endolymphatic duct, was directly responsible for the Menière's-like symptoms.

POSTERIOR FOSSA MENINGIOMAS PRESENTING WITH MÉNIÈRE'S-LIKE SYMPTOMS

Neurosurgery ◽  
2008 ◽  
Vol 63 (5) ◽  
pp. E1001-E1001 ◽  
Author(s):  
Daniel H. Coelho ◽  
J. Thomas Roland ◽  
John G. Golfinos
Keyword(s):  
Posterior Fossa ◽  
Endolymphatic Hydrops ◽  
Delayed Diagnosis ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Endolymphatic Sac ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Ménière's Disease

Abstract OBJECTIVE AND IMPORTANCE In rare cases, posterior fossa meningiomas can involve the endolymphatic sac. Such involvement can result in endolymphatic hydrops and a constellation of symptoms suggestive of Ménière's disease. The diagnosis and management of patients with these tumors is discussed. CLINICAL PRESENTATION Three patients, each of whom presented with symptoms consistent with Ménière's disease, were found to have posterior fossa meningiomas limited to the dura overlying the endolymphatic sac. INTERVENTION All 3 patients were diagnosed by magnetic resonance imaging and underwent complete surgical resection. In all cases, the symptoms resolved after tumor removal. CONCLUSION Clinicians should have a degree of suspicion of posterior fossa meningioma when patients present with symptoms suggestive of Ménière's disease. Failure to do so may result in delayed diagnosis or worse outcomes for an otherwise treatable tumor.

Computer-Aided and Graphic Reconstruction of the Human Endolymphatic Duct and Sac

1980 ◽  
Vol 89 (6_suppl2) ◽  
pp. 23-32 ◽  
Author(s):  
Juan-Carlos M. Antunez ◽  
Fred H. Linthicum ◽  
Frank R. Galey ◽  
Gilbert D. McCann
Keyword(s):  
Endolymphatic Hydrops ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Computer Aided ◽  
Endolymphatic Duct ◽  
Ménière's Disease ◽  
Histopathological Evidence

The anatomy of the human endolymphatic duct system of three cases — one with Menière's syndrome (with no histopathological evidence of endolymphatic hydrops), one with Menière's disease (with histopathological evidence of endolymphatic hydrops), and one with no evidence of disease — has been studied by means of computer-aided and graphic reconstruction from serial sections of temporal bones. The reconstructions have revealed a canalicular arrangement of the epithelial lining of the rugose portion of the human endolymphatic sac. Accordingly, new nomenclature, “pars canalicularis,” is suggested for this portion. The computer produced lateral and medial views of the endolymphatic duct and sac of the patient with Menière's syndrome. The computer also calculated the luminal volume, the surface area of the epithelium, and the surface-to-volume ratio of the rugose portion of the sac. In addition, the authors graphically reconstructed the rugose portion of the sac of all three cases. Measurements of the dimensions of these reconstructions were made, from which the luminal volume was estimated. The reconstructed images and the calculations allowed quantitative comparison of the microscopic anatomy of the rugose portion of the sac in the Menière's syndrome and Menière's disease ears with that in an ear without evidence of disease. Significant differences were found in the volumes of the rugose portion of the sac of the three cases. The results suggest that the luminal volume of the rugose portion of the sac of Menière's disease patients may be significantly reduced. The authors speculate that endolymphatic hydrops may be the result of a loss of epithelial surface area in the canalicular portion, thus diminishing its resorptive function. The computer and graphic reconstruction techniques in conjunction with their analytical capabilities provide a new method for studying inner ear structures. These techniques have the potential to expand the capabilities of quantitative morphology and provide the means for deriving clinically useful data from histopathological and ultrastructural material.

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.

scholarly journals Ménière's Disease

1981 ◽  
Vol 74 (3) ◽  
pp. 183-189 ◽  
Author(s):  
Andrew W Morrison
Keyword(s):  
Endolymphatic Hydrops ◽  
Meniere’S Disease ◽  
Cellular Level ◽  
Menière’S Disease ◽  
Prognostic Indicators ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Endolymphatic Duct ◽  
Ménière's Disease

The otological practice at The London Hospital provides very large numbers of patients with Ménière's disease from a busy department. This clinical material has been utilized as much as possible, without research assistants or funds, to examine some clinical and pathological aspects of the disease which might have a bearing on aetiology. The investigation procedures which are likely to lead to an earlier and more certain diagnosis are outlined and prognostic indicators are mentioned. It would appear that there may be an hereditary predisposition to progressive idiopathic endolymphatic hydrops. Potential sufferers tend to have migraine, a family history of migraine, minor degrees of basilar impression associated with an abnormally located endolymphatic duct and sac, a more emotional personality, and possibly an association with blood group A. The experimental and clinicopathological evidence supports the view that the endolymphatic duct and sac have an important role in the pathogenesis of both idiopathic and secondary hydrops. Ultrastructural examination is continuing and may shed more light on the pathology at a cellular level. There is, as yet, no cure for Ménière's disease and sufferers will be incapacitated in varying degrees, often severely, for the rest of their days.

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