China
Africa
Explore chapters and articles related to this topic
Vestibular Disorders and Rehabilitation
Published in R James A England, Eamon Shamil, Rajeev Mathew, Manohar Bance, Pavol Surda, Jemy Jose, Omar Hilmi, Adam J Donne, Scott-Brown's Essential Otorhinolaryngology, 2022
There is some evidence to support the effectiveness of intratympanic steroids. Endolymphatic duct surgery and vestibular nerve section are surgical options for refractory cases that allow hearing preservation. Intratympanic gentamicin and labyrinthectomy tend to be reserved for patients with significant SNHL or refractory symptoms due to the risks of worsening hearing (3–21% rate of hearing loss for low-dose gentamicin injections, complete hearing loss for labyrinthectomy) or causing persistent vestibular dysfunction.
The Special Sense Organs and Their Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
Surgical terms relating to the treatment of Meniere's disease and incapacitating vertigo include middle fossa vestibular nerve section, trans-labyrinthine labyrinthectomy, retrolabyrinthine vestibular neurectomy, sac incision, endolymphatic subarachnoid/mastoid shunting, and cochleo-endolymphatic shunt.
Common otology viva topics
Published in Joseph Manjaly, Peter Kullar, Advanced ENT Training, 2019
Ablative treatmentsAminoglycosides: Vestibulotoxic agent acting as a partial chemolabyrinthectomy, via a mechanism involving NMDA receptor binding and production of reactive oxygen species.Vestibular nerve section: Neurosurgical/neurotological procedure considered if failed gentamicin treatment, aims to control vertigo and preserve hearing.Labyrinthectomy: Drilling out the whole of the inner ear, may be considered where there is no serviceable hearing.
Hearing preservation/rehabilitation surgery for small vestibular schwannoma: preliminary experience with the presigmoid retrolabyrinthine approach
Published in Acta Oto-Laryngologica, 2021
Jie Wang, Yong Li, Xingmei Wei, Jingyuan Chen, Lifang Zhang, Xinping Hao, Yongxin Li
Partial labyrinthectomy (Figure 3) was performed in three patients. One achieved hearing preservation, a preservation rate similar to that of another study [9]. In that study, the authors conducted a systematic analysis of 84 patients with AN from seven studies and 55 patients with other lesions from three studies and found that the hearing preservation rate after partial labyrinthectomy was 31% for patients with AN. However, for patients with non-AN, the rate was 76%. A reason for hearing loss in patients with VS resection is that surgery may affect the cochlear nerve. Magliulo et al. [17] used postoperative CT and MRI in patients undergoing partial labyrinthectomy and they demonstrated that this approach does not cause any detectable ultrastructural injury. The semicircular occlusion did not result in hearing loss, which is a fundamental factor for hearing preservation in partial labyrinthectomy. Nevertheless, vestibular damage affects hearing, which reminds us that semicircular canal resection should be posterior to the vestibule and the SSC and PSC ampullae. This is also a fundamental factor in successful hearing preservation [17]. Moreover, when the semicircular canal is closed, the bone wax should be directed away from the ampulla, because it is vulnerable to ototoxicity.
Cochlear implantation in Ménière’s disease: a systematic review of literature and pooled analysis
Published in International Journal of Audiology, 2020
Federica Di Berardino, Giorgio Conte, Federica Turati, Monica Ferraroni, Diego Zanetti
Many arguments have been raised against CI in MD patients; first being the fluctuations of the CI maps, which may jeopardise the auditory performances (McNeill and Eykamp 2016). A second issue is the possible detrimental effect of the CI on the vestibular system and the need to address the diseased posterior labyrinth (the semicircular canals and vestibules) during the same surgical session or in advance. On both topics, the evidence in the literature was controversial. According to some authors, the fluctuation of hearing in relation to CI maps may jeopardise the auditory performance (McNeill and Eykamp 2016), while others deny this effect (Vermeire et al. 2014; Canzi et al. 2017). An improvement of vertigo after CI has been reported by some authors, independently from a simultaneous or earlier labyrinthectomy (McRackan et al. 2014; Stahle 1976), while for others (Canzi et al. 2017; Mukherjee et al. 2017) previous or concomitant treatments guaranteed a better recovery.
Meniere disease subtyping: the direction of diagnosis and treatment in the future
Published in Expert Review of Neurotherapeutics, 2022
Sulin Zhang, Zhaoqi Guo, E. Tian, Dan Liu, Jun Wang, Weijia Kong
The researchers have reached a consensus on the treatment of MD. Patients should change the lifestyle, receive vestibular rehabilitation during the intercortical period and if possible, psychotherapy. First-line conservative medications, i.e. diuretics and betahistine or local pressure therapy should be used. When medical treatment fails, a second-line treatment that is, the intratympanic injection of steroids, should be used. The third-line treatment, the endolymphatic sac surgery or the intratympanic injection of gentamicin should be used, depending on the hearing function. The last-ditch option is labyrinthectomy, a destructive surgery, without or in combination with cochlear implantation or vestibular nerve resection [59, 60].