THE IMPACT OF VESTIBULAR NERVE PATHOLOGY ON THE TREATMENT OF MENIERE'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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Demyelination of Vestibular Nerve Axons in Unilateral Ménière's Disease

Ear Nose & Throat Journal ◽

10.1177/014556130208101113 ◽

2002 ◽

Vol 81 (11) ◽

pp. 785-789 ◽

Cited By ~ 2

Author(s):

Robert F. Spencer ◽

Aristides Sismanis ◽

Jefferson K. Kilpatrick ◽

Wayne T. Shaia

Keyword(s):

Medical Management ◽

Light And Electron Microscopy ◽

Disease Process ◽

Meniere’S Disease ◽

Vestibular Nerve ◽

Menière’S Disease ◽

Meniere's Disease ◽

Ménière’S Disease ◽

Menière's Disease ◽

Ménière's Disease

We conducted a study to determine whether vestibular nerves inpatients with unilateral Ménière's disease whose symptoms are refractory to medical management exhibit neuropathologic changes. We also endeavored to determine whether retrocochlear abnormalities are primary or secondary factors in the disease process. To these ends, we obtained vestibular nerve segments from five patients during retrosigmoid (posteriorfossa) neurectomy, immediately fixed them, and processed them for light and electron microscopy. We found that all five segments exhibited moderate to severe demyelination with axonal sparing. Moreover, we noted that reactive astrocytes produced an extensive proliferation of fibrous processes and that the microglia assumed a phagocytic role. We conclude that the possible etiologies of demyelination include viral and/or immune-mediated factors similar to those seen in other demyelinating diseases, such as multiple sclerosis and Guillain-Barré syndrome. Our findings suggest that some forms of Ménière's disease that are refractory to traditional medical management might be the result of retrocochlear pathology that affects the neuroglial portion of the vestibular nerve.

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Subcellular Abnormalities of Vestibular Nerve Morphology in Patients With Intractable Meniere's Disease

Frontiers in Neurology ◽

10.3389/fneur.2019.00948 ◽

2019 ◽

Vol 10 ◽

Cited By ~ 1

Author(s):

Pengjun Wang ◽

Huaming Zhu ◽

Wen Lu ◽

Qiang Song ◽

Zhengnong Chen ◽

...

Keyword(s):

Meniere’S Disease ◽

Vestibular Nerve ◽

Menière’S Disease ◽

Meniere's Disease ◽

Ménière’S Disease ◽

Menière's Disease ◽

Ménière's Disease

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Alternative Surgeries for Vertigo in Meniere's Disease

Otolaryngology ◽

10.1016/s0194-5998(05)80075-0 ◽

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.

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