Current Status of Surgery for Meniere's Disease

Glasscock, Michael E.; Kveton, John F.; Christiansen, Sidney G.

doi:10.1177/019459988409200115

Cited by 28 publications

(10 citation statements)

References 15 publications

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“…Twelve of our 13 patients (92%) had characterized vertigo as disabling in daily life preoperatively versus 1 patient (8%) postoperatively. Although these case numbers are small, our functional results are superior to those reported for endolymphatic sac surgery over a similar follow-up period [9,15]. Our results are also comparable to those of chemical labyrinthectomy [4,13] and those obtained with surgical destructive procedures.…”

Section: Efficacy Of Jugular Bulb Loweringsupporting

confidence: 69%

Surgical treatment of the high jugular bulb in patients with M�ni�re's disease and pulsatile tinnitus

Couloigner

Grayeli

Bouccara

et al. 1999

European Archives of Oto-Rhino-Laryngology

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The aim of this retrospective study was to evaluate the functional results of surgical lowering of the high jugular bulb in the treatment of patients with Ménière's disease and pulsatile tinnitus. Fifteen patients with disabling Ménière's disease associated with pulsatile tinnitus and a high and medial jugular bulb were included in this study. As treatment a complete mastoidectomy was performed, after which the jugular bulb was freed by an infralabyrinthine and subfacial approach. The bulb was then displaced downwards with surgical wax. Functional results of surgery were assessed by a questionnaire according to the 1995 guidelines of the United States American Academy Committee on Hearing and Equilibrium, audiometric and vestibular tests, and by magnetic resonance and computed tomographic imaging with vascular sequences. Surgical treatment was contraindicated in two cases: one had hypoplasia of the contralateral sigmoid sinus and the other a small petrous hemangioma located around the jugular bulb that was discovered peroperatively. Among the 13 patients treated by definitive surgery, attacks of vertigo were reported as disabling in 12 cases preoperatively (92%) versus 1 (8%) after surgical treatment. No significant change in hearing was observed after surgery. Tinnitus had been reported in all patients preoperatively and decreased in intensity in four (31%) and disappeared in three (23%) after surgery.

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Section: Efficacy Of Jugular Bulb Loweringsupporting

confidence: 69%

Surgical treatment of the high jugular bulb in patients with M�ni�re's disease and pulsatile tinnitus

Couloigner

Grayeli

Bouccara

et al. 1999

European Archives of Oto-Rhino-Laryngology

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“…Over the years, various shunting techniques have emerged, including mastoid shunts, subarachnoid shunts, and endolymphatic duct valve placement (11,12,15,16,22,24,42,45,55,56,71). Over the years, various shunting techniques have emerged, including mastoid shunts, subarachnoid shunts, and endolymphatic duct valve placement (11,12,15,16,22,24,42,45,55,56,71).…”

Section: Shuntingmentioning

confidence: 99%

“…Since House, many have performed a subarachnoid shunt to treat medically recalcitrant MD, reporting complete or substantial vertigo control (Category A/B) ranging from 66% to 93% (11,13,20,22). Despite the early successes of this technique, it has been rarely performed for the last 25 years.…”

Section: Shuntingmentioning

confidence: 99%

Endolymphatic Sac Surgery for Ménière’s Disease

Ak¹,

Lambert²,

Nguyen³

et al. 2014

Otology &Amp; Neurotology

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Endolymphatic sac surgery (sac decompression or mastoid shunt) is effective at controlling vertigo in the short term (>1 yr of follow-up) and long term (>24 mo) in at least 75% of patients with Ménière's disease who have failed medical therapy. Sac decompression and mastoid shunting techniques provide similar vertigo control rates. Mastoid shunting, with and without silastic, also provides similar vertigo control rates. Non-use of silastic, however, seems to maintain stable or improved hearing in more patients compared to silastic sheet placement. The data suggest that, once the sac is opened, placing silastic does not add benefit and may be deleterious.

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“…Another group found 65% with improvement of vertigo at 3 years of follow-up and 50% with improvement at 10 years of follow-up after endolymphatic shunt surgery [32]. This and other reports favor the use of endolymphatic shunt surgery in patients with serviceable hearing and recurrent vertigo due to unilateral Meniere's disease.…”

Section: Endolymphatic-mastoid Shunt Surgerymentioning

confidence: 64%

Meniere’s syndrome

Fife

1999

Curr Treat Options Neurol

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The primary goals of treatment in Meniere's syndrome are to control attacks of vertigo and, if possible, to arrest the progression of hearing loss. Initial treatment consists of rigid dietary sodium restriction, possibly with the addition of a thiazide diuretic. If disabling attacks of vertigo persist despite sodium restriction, surgical intervention should be considered. Endolymphatic shunting is an option for patients who desire a less invasive surgical remedy, but recurrence of vertigo occurs in about 40% of cases. Vestibular nerve ablative surgery is the definitive surgical treatment for patients with intractable attacks of vertigo who still have useful hearing on the affected side. Labyrinthectomy is a surgical option when there is no serviceable hearing in the damaged ear. Intra-aural gentamicin instillation is an option in carefully selected cases.

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Current Status of Surgery for Meniere's Disease

Cited by 28 publications

References 15 publications

Surgical treatment of the high jugular bulb in patients with M�ni�re's disease and pulsatile tinnitus

Surgical treatment of the high jugular bulb in patients with M�ni�re's disease and pulsatile tinnitus

Endolymphatic Sac Surgery for Ménière’s Disease

Meniere’s syndrome

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