Surgical Ablation Of The Vestibular System In The Treatment Of Meniere’s Disease

Silverstein, Herbert; Rosenberg, Seth I.; Arruda, Johnny; Isaacson, Jon E.

doi:10.1016/s0030-6665(20)30149-3

Cited by 21 publications

(3 citation statements)

References 31 publications

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“…The majority of studies show a stable hearing in 50-70 per cent of patients regardless of surgical technique, suggesting that none of the procedures employed can actually alter the natural course of the hearing loss. [1][2][3][4][5]13,[15][16][17][18] Other studies on patients who have not been operated on have shown that hearing was stable as well and found no statistical difference between patients who underwent surgery and those who did not.…”

Section: Discussionmentioning

confidence: 99%

“…The role of selective vestibular neurotomy (VN) has become widely accepted in the treatment of medically refractory vertigo in Meniè re's disease and other ear-related vertigo. [1][2][3][4] The main advantage of VN is that, for the majority of patients, hearing is preserved while vertigo is controlled. 5 However, over the years, the best approach for sectioning the vestibular nerve continues to be a matter of debate and controversy.…”

Section: Introductionmentioning

confidence: 99%

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Posterior fossa vestibular neurotomy as primary surgical treatment of Menière’s disease: a re-evaluation

et al. 2002

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Fifty-eight patients underwent vestibular neurotomy via the posterior fossa approach between September 1992 and December 1998 at the ENT department of Legnano. All patients presented a history of disabling unilateral Menière's disease and underwent complete neuro-otologic evaluation following the 1985 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guidelines. All patients underwent MRI imaging, ABR and electronystagmographic testing before surgery. Objective analysis of results is reported using the criteria published by the Committee on Hearing and Equilibrium of the AAO-HNS in 1985. According to the AAO formula, 52 patients obtained a score of 0, indicating complete control of major vertigo spells, while four were classified within the 'substantial control' group. Immediate hearing results indicated that 93 per cent of the patients maintained a level within 10 dB from the pre-operative level. Only one patient experienced a subtotal hearing loss yet retained measurable hearing. No major complications were reported. We conclude that a retrosigmoid approach to vestibular neurotomy can be considered a safe and effective procedure in relieving medically refractory vertigo in Menière's disease while preserving the hearing. Tinnitus and long-term hearing deterioration are not influenced by the procedure.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Posterior fossa vestibular neurotomy as primary surgical treatment of Menière’s disease: a re-evaluation

et al. 2002

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“…A logical explanation for this dramatic result could not be offered at that time. Significant improvement in hearing was noted in 20-30% of MD patients after selective vestibular nerve section or excision [4][5][6][7][8][9]. The common ORL 2021;83:144-150 DOI: 10.1159/000511113 theme in these reports is that the sensorineural hearing loss in MD can be improved following vestibular ablation.…”

Section: Introductionmentioning

confidence: 89%

On the Nature of Hearing Loss in Méniere’s Disease

Gacek¹

2021

ORL

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Objective: To explain the pathophysiology of the hearing loss in Ménière’s disease (MD). Background: In a previous report, we described a dramatic recovery of hearing in 12/31 patients with MD using antiviral (AV) drugs. The hearing loss in the remaining 19 patients with a longer history of MD remained unchanged or else worsened. Vertigo control was complete in the group with improved hearing but poorer in the group with greater hearing loss (and a longer MD history). Since achieving the recovery of hearing and control of the vertigo using AV drugs in these patients with a shorter history (≤2 years) of MD, we have continued to record dramatic hearing recovery in MD when patients have a shorter history of symptoms. We describe this here in 5 representative MD patients. We feel that the most likely explanation for the outcome is the removal of viral nucleic acids (NA) from the organ of Corti. Summary: A likely explanation for the sensorineural hearing loss in MD is paralysis of the cochlear amplifier function of the outer hair cells due to the toxicity ofNA. These NA are released from neurotropic viruses located in the vestibular nerve ganglion. Key Messages: (1) Viruses (Herpes family) are the cause of the symptoms in MD. (2) Hearing loss is the result of viral NA in the organ of Corti. (3) A short history of MD symptoms (<2 years) favors hearing recovery.

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