The Role of Labyrinthectomy and Cochlear Implantation in Meniere's Disease

Wareing, Michael J.; O’Connor, Alec Fitzgerald

doi:10.1177/014556139707600911

Cited by 14 publications

(13 citation statements)

References 34 publications

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“…8 Damage or degeneration of these structures would lead to a poor outcome following cochlear implantation. However, several studies have illustrated excitability of the post-labyrinthectomy ear.…”

Section: Discussionmentioning

confidence: 99%

“…8 Similarly, the cochlea can become ossified, leading to difficulties in implantation. 8 Some authors have suggested that these problems can be avoided by performing implantation immediately following labyrinthectomy. However, in the more common case of initial labyrinthectomy followed by later failure of the other ear, this is not a viable solution.…”

Section: Discussionmentioning

confidence: 99%

“…However, in the more common case of initial labyrinthectomy followed by later failure of the other ear, this is not a viable solution. 8 In order to overcome this problem, Kemink et al have suggested that a plastic obturator be implanted in the scala tympani to maintain its patency should cochlear implantation be later required. 11 However, cases such as ours illustrate that, even 20 years post-labyrinthectomy, cochlear implantation may be successful without such measures.…”

Section: Discussionmentioning

confidence: 99%

“…7 Cochlear implantation has been used to rehabilitate profoundly deafened adults for more than 25 years. 8 Since its early development, its role has continued to expand.…”

Section: Introductionmentioning

confidence: 99%

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Delayed cochlear implantation after surgical labyrinthectomy

2011

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Changes to the cochlea and vestibule following surgical labyrinthectomy include cochlear ossification and obliteration of the vestibule. These issues have been thought to limit the potential for cochlear implantation, especially when there is a significant delay between the two procedures. However, delayed cochlear implantation, even decades after labyrinthectomy, remains a viable treatment option which can benefit selected patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…7 Cochlear implantation has been used to rehabilitate profoundly deafened adults for more than 25 years. 8 Since its early development, its role has continued to expand.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Delayed cochlear implantation after surgical labyrinthectomy

2011

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“…A number of case series have documented its effectiveness and relatively low morbidity [34][35][36]Class III]. Candidates for labyrinthectomy should have normal middle and inner ear function in the contralateral ear.…”

Section: Labyrinthectomymentioning

confidence: 99%

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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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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The Role of Labyrinthectomy and Cochlear Implantation in Meniere's Disease

Cited by 14 publications

References 34 publications

Delayed cochlear implantation after surgical labyrinthectomy

Delayed cochlear implantation after surgical labyrinthectomy

Meniere’s syndrome

Cochlear Implantation in Ménière’s Disease

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