Chemical labyrinthectomy and cochlear implantation for Menière's disease – An effective treatment or a last resort?

Morgan, Marlene; Flood, L M; Hawthorne, Maurice; Raje, S

doi:10.1017/s0022215100144792

Cited by 17 publications

(15 citation statements)

References 12 publications

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“…Case reports have demonstrated successful hearing rehabilitation with CI after surgical labyrinthectomy, 23,24 and similar results have been reported after intratympanic gentamycin therapy. 5 Our cohort included 2 (patients 2 and 6) who underwent such procedures in the contralateral ear. Nevertheless, labyrinthectomy, either surgical or pharmacologic, should not be a contraindication to CI.…”

Section: Discussionmentioning

confidence: 99%

“…A review of the available literature revealed that only a handful of English-language articles investigating CI in the setting of MD have been published. [4][5][6][7][8] Most of these are single case reports and opinion articles and focus primarily on the effects of CI on hearing performance in patients with MD. Only 1 study has addressed the effects of CI on the nonhearing aspects of MD.…”

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confidence: 99%

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Cochlear Implantation in Ménière’s Disease

Fife

Lewis

May

et al. 2014

JAMA Otolaryngol Head Neck Surg

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Ménière's disease (MD) is characterized by cochleovestibular dysfunction that manifests as fluctuating sensorineural hearing loss (SNHL), episodic vertigo, aural fullness, and tinnitus. A review of the available literature revealed that only a handful of English-language articles investigating CI in the setting of MD have been published. [4][5][6][7][8] Most of these are single case reports and opinion articles and focus primarily on the effects of CI on hearing performance in patients with MD. Only 1 study has addressed the effects of CI on the nonhearing aspects of MD. 4Patients with severe to profound bilateral SNHL and poor word recognition capability due to MD stand to experience considerable benefit from CI. The objectives of this study are to (1) determine whether CI in patients with MD improves hearing performance as measured by standard CI audiometric testing and (2) describe the impact of CI on subjective auditory and vestibular quality-of-life measures.IMPORTANCE Though the effects of cochlear implantation (CI) on patients with hearing loss has been well described, its effect on the auditory and vestibular symptoms in patients with Ménière's disease (MD) has not been firmly established.OBJECTIVES To determine whether CI in patients with MD improves hearing performance as measured by standard post-CI audiometric testing and to describe the impact of CI on subjective auditory and vestibular quality-of-life measures. DESIGN, SETTING, AND PARTICIPANTSRetrospective review of all patients with MD 18 years or older who met diagnostic criteria for definite MD and underwent CI at Wake Forest University Baptist Medical Center, a tertiary care academic medical center, from 2000 through 2012.INTERVENTIONS Patients were invited to answer questions regarding their current hearing ability, subjective perception of symptoms, and functional status related to their MD before and after CI. Patient records were reviewed for pertinent information. Results were then analyzed for statistical significance. MAIN OUTCOMES AND MEASURESPre-CI and post-CI sentence testing scores, frequency and severity of MD vestibular and auditory symptoms via the MD Functional Level Scale (FLS), and hearing quality of life via the Hearing Handicap Index were reviewed.RESULTS Eleven CIs were performed in 10 patients. Mean long-term follow-up was 41 months. The mean age at first implantation was 64 years. The mean sentence testing scores in quiet improved from 22.8% before CI to 77.0% after CI (P < .001) at the most recent follow-up. Mean (SD) pre-CI and post-CI MD-FLS vestibular scores were similar: 3.9 (1.9) and 3.4 (1.9) (P = .52).CONCLUSIONS AND RELEVANCE Patients with MD who undergo CI are capable of achieving substantial receptive communication improvement comparable to the gains experienced by patients without MD. Implantation seems to neither adversely alter the natural history of vestibular function nor notable exacerbate auditory symptoms.

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Section: Discussionmentioning

confidence: 99%

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confidence: 99%

Cochlear Implantation in Ménière’s Disease

Fife

Lewis

May

et al. 2014

JAMA Otolaryngol Head Neck Surg

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“…10,11 Only the cochlear neurons are required for electrical stimulation, but with very high ablative doses of gentamicin, the risk of damage and reduced efficacy of cochlear implantation remains a possibility. In 1997, Wareing and O'Connor 9 published a review of the literature and suggested that this would be a viable treatment option and that this method of labyrinthectomy may be preferable in causing less trauma to the cochlea than transcanal labyrinthectomy.…”

Section: Discussionmentioning

confidence: 99%

Simultaneous Labyrinthectomy With Cochlear Implantation in Patients With Bilateral Ménière’s Disease

MacKeith

Bottrill

Ramsden

2014

Ann Otol Rhinol Laryngol

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“…In MD, labyrinthectomy was first performed in 1895 as a destructive but very effective option for patients with treatment-resistant vertigo [9]. Recently this treatment has become more interesting again as hearing can be restored with a cochlear implant in a simultaneous procedure [10][11][12][13].…”

Section: Introductionmentioning

confidence: 99%

Long-term vertigo control after cochlear implantation in patients with end-stage Menière’s disease

Kurz

Auinger

Arnoldner

2020

Wien Klin Wochenschr

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Summary Background Menière’s disease (MD) is a symptom complex which is characterized by episodes of vertigo, tinnitus and fluctuating sensorineural hearing loss, which worsens during the course of the disease. Objective Vertigo attacks (MD functional level scale) before compared to after cochlear implantation in patients with end-stage MD. Design and patients In this questionnaire-based cross-sectional study eight patients with end-stage MD, who received a cochlear implant (CI) were analyzed. Main outcome measure The effect of the CI on vertigo was measured preoperatively and postoperatively with the Menière’s disease functional level scale and the Menière’s disease outcome questionnaire. The primary outcome parameter influence of vertigo attacks on daily living was analyzed using the non-parametric Wilcoxon signed rank test before and after CI. Setting Department of otolaryngology of a medical university. Results The primary outcome measure influence of vertigo attacks on daily living as measured by the MD functional level scale improved significantly after CI. Conclusion A CI can be an adequate treatment for vertigo attacks in patients with end-stage MD; however, due to the small sample size additional (multicenter) trials are necessary to confirm the findings.

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Chemical labyrinthectomy and cochlear implantation for Menière's disease – An effective treatment or a last resort?

Cited by 17 publications

References 12 publications

Cochlear Implantation in Ménière’s Disease

Cochlear Implantation in Ménière’s Disease

Simultaneous Labyrinthectomy With Cochlear Implantation in Patients With Bilateral Ménière’s Disease

Long-term vertigo control after cochlear implantation in patients with end-stage Menière’s disease

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