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Translabyrinthine vestibular neurectomy and simultaneous cochlear implant for Ménière's disease. | LitMetric

Translabyrinthine vestibular neurectomy and simultaneous cochlear implant for Ménière's disease.

Acta Neurochir (Wien)

Department of Otorhinolaryngology, University of Pavia, IRCCS Policlinico "S. Matteo" Foundation, Viale Camillo Golgi, 19, 27100, Pavia, Italy.

Published: January 2017

AI Article Synopsis

  • The study focuses on evaluating the effectiveness of translabyrinthine vestibular nerve section and simultaneous cochlear implant for patients with Ménière's disease who have not responded to other treatments.
  • Four adult patients with intractable unilateral Ménière's disease and the inability to hear received the treatment and were assessed for improvements in vertigo, hearing loss, and overall quality of life.
  • Results showed significant reductions in vertigo attacks and tinnitus, as well as improved hearing ability, indicating that this combined surgical approach may be beneficial for managing Ménière's disease symptoms.

Article Abstract

Background: Surgical management of Ménière's disease (MD) is recommended in case of medical and intratympanic treatment failures. Translabyrinthine vestibular nerve section has been considered the gold standard for denervation procedures in order to control vertigo attacks, although at the cost of sacrificing residual hearing. To the best of our knowledge, no work has been published with regard to a group of patients submitted to translabyrinthine vestibular neurectomy and simultaneous cochlear implant for MD. The aim of the present study was to assess the effectiveness of translabyrinthine vestibular nerve section and simultaneous cochlear implant in a prospective study.

Methods: All adult patients (over 18 years of age) with a diagnosis of intractable unilateral definite MD and useless residual hearing function were enrolled after medical and intratympanic treatment failures. Pre- and postoperative otoneurological evaluation concerned: frequency of vertigo attacks, head impulse test and caloric testing, pure tone average and speech perception audiometry in quiet conditions, tinnitus handicap inventory test, functional level scale and rate of vertigo control, dizziness handicap inventory test, and MD patient-oriented severity index. At least 6 months of follow-up were needed to be enrolled in the study.

Results: Four patients were included in the study. Translabyrinthine vestibular nerve section and simultaneous cochlear implant seemed to considerably improve the disabling effects of MD, achieving a good control of vestibular symptoms (mean pre/postoperative vertigo attacks per month: 16.5/0), resolving hearing loss (mean pre/postoperative pure tone average in the affected ear: 86.2/32.5 dB), improving the tinnitus (mean pre/postoperative tinnitus handicap inventory test: 77.2/6), and finally increasing the overall quality-of-life parameters.

Conclusions: In our preliminary report, translabyrinthine vestibular nerve section and simultaneous cochlear implant showed encouraging results in order to definitively control both vestibular and cochlear symptoms during the same therapeutic procedure.

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Source
http://dx.doi.org/10.1007/s00701-016-2996-9DOI Listing

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