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

PRILOZI ◽  
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.

Endolymphatic sac surgical anatomy and transmastoid decompression of the sac for the management of Ménière's disease

2014 ◽  
Vol 128 (6) ◽  
pp. 488-493 ◽  
Author(s):  
R R Locke ◽  
J Shaw-Dunn ◽  
B F O'Reilly
Keyword(s):  
Semicircular Canal ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Endolymphatic Sac ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Surgical Trauma ◽  
Menière's Disease ◽  
Posterior Semicircular Canal ◽  
Ménière's Disease

AbstractBackground:Decompression of the endolymphatic sac for Ménière's disease gives unpredictable results. This may be because the sac is difficult to identify and decompress accurately without causing surgical trauma.Methods:In order to test this idea, transmastoid decompression was simulated in 5 cadaver half heads and the anatomy of the endolymphatic sac was reviewed in a further 14 specimens.Results:The endolymphatic sac was found and confirmed by histology in all five simulated decompressions. A newly described feature, a trapezoid thickening of dura, was a useful guide. The review showed that the sac was constant proximally, but variable distally. The posterior semicircular canal, posterior fossa dura and sigmoid sinus are at risk during dissection.Conclusion:The endolymphatic sac may be identified on inspection by an overlying patch of dura, thereby reducing exploratory dissection. It is best to decompress the sac as far proximally as possible, whilst protecting the posterior semicircular canal.

scholarly journals Triple Semicircular Canal Occlusion Combined with Endolymphatic Sac Decompression: An Effective Surgical Strategy for Vertigo Control of Intractable Meniere’s Disease

2021 ◽  
Author(s):  
Bingbin Xie ◽  
Meiqun Wang ◽  
Yunxia Jiang ◽  
Wen Xie ◽  
Shaorong Zhang ◽  
...  
Keyword(s):  
Semicircular Canal ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Endolymphatic Sac ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Equilibrium Function ◽  
Ménière's Disease ◽  
Semicircular Canal Occlusion

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.

Vestibular function at the end of intratympanic gentamicin treatment of patients with Ménière's disease

2005 ◽  
Vol 15 (1) ◽  
pp. 49-58
Author(s):  
Nicolas Perez ◽  
Julio Rama-Lopez
Keyword(s):  
Time Constant ◽  
Vestibular Function ◽  
Meniere’S Disease ◽  
Menière’S Disease ◽  
Meniere's Disease ◽  
Ménière’S Disease ◽  
Menière's Disease ◽  
Bedside Examination ◽  
Intratympanic Gentamicin ◽  
Ménière's Disease

The aim of this study is to analyze the effects of intratympanic gentamicin injections on vestibular function in 33 patients with unilateral Meniere's Disease (according to AAO-HNS guidelines 1995) that had been unresponsive to medical therapy for at least one year. In such patients, the results of bedside examination of vestibular function vestibular examination is compared to those from laboratory tests. Intratympanic gentamicin injections (27 mg/ml) were performed at weekly intervals until symptoms or signs of vestibular hypofunction developed in the treated ear. Vestibular function was evaluated in two different rotatory chair tests. The parameters that were specifically considered were the time constant of the vestibulo-ocular reflex (VOR) after impulse rotation with a peak chair velocity of 100°s-1, and the phase and gain of the VOR after the sinusoidal harmonic acceleration (SHA) test with a peak chair velocity of 50°s-1. After treatment, both the time constant of the VOR after rotation towards the treated side and the gain in the SHA test were significantly reduced. These reductions were in accordance with the number of additional signs observed upon bedside examination at the end of the treatment. The changes observed in the VOR correlate well with the results of bedside examination of vestibular function, which in turn reflects the damage induced by intratympanic gentamicin injection.

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.

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