Occlusion of the Lateral Semicircular Canal, Endolymphatic Sac Surgery, and Cochlear Implantation: A Low Destructive Treatment for Unilateral Ménière's Disease and Deafness.

IF 1.6 4区 医学 Q2 AUDIOLOGY & SPEECH-LANGUAGE PATHOLOGY Audiology and Neuro-Otology Pub Date : 2024-01-01 Epub Date: 2024-02-07 DOI:10.1159/000535937
Conrad Riemann, Rayoung Kim, Christoph J Pfeiffer, Holger Sudhoff, Ingo Todt
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Abstract

Introduction: Surgical treatment of Ménière's disease (MD) and deafness aims to treat vertigo and hearing disabilities. Current treatment options like labyrinthectomy and cochlear implantation (CI) have shown acceptable results but are destructive. Less destructive procedures, like the occlusion of the lateral semicircular canal and endolymphatic sac surgery, have been shown to be successful in vertigo control. The combination of both procedures with CI has not been investigated; therefore the objective of this study was to investigate the outcome of this combination in patients with single-sided MD and moderately severe to complete sensorineural hearing loss.

Methods: In this retrospective study, 10 patients with single-sided MD and moderately severe to complete sensorineural hearing loss were included. In all of them, a single-staged surgery, which consisted of CI, endolymphatic sac surgery, and occlusion of the lateral semicircular canal, was performed. The surgery was performed after a failed conservative therapy trial. The clinical outcome was evaluated by the Dizziness Handicap Inventory (DHI) and audiological tests. These were assessed preoperatively, 3 and 6 months after surgery. An MRI with a hydrops sequence was performed to support the clinical diagnosis.

Results: After the combined surgery, the mean DHI testing improved significantly from 71 to 30. Mean audiological monosyllabic speech testing outcome with the cochlea implant was 65% at 65 dB. The residual hearing of 2 patients could be preserved after the surgical procedure.

Conclusion: The combination of occlusion of the lateral semicircular canal, endolymphatic sac surgery, and CI is an efficient low traumatic treatment for patients with a single-sided MD and moderately severe to complete sensorineural hearing loss.

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外侧半规管闭塞、内淋巴囊手术和人工耳蜗植入术:单侧梅尼埃病和耳聋的低破坏性治疗。
导言:梅尼埃病(MD)和耳聋的手术治疗旨在治疗眩晕和听力残疾。目前的治疗方案,如迷路切除术和人工耳蜗植入术(CI),效果尚可,但具有破坏性。破坏性较小的手术,如外侧半规管闭塞术和内淋巴囊手术,已被证明能成功控制眩晕。目前尚未对这两种手术与 CI 的结合进行研究;因此,本研究的目的是对单侧 MD 和中重度至完全性感音神经性听力损失患者进行这种结合的结果研究:在这项回顾性研究中,共纳入了 10 名单侧 MD 和中重度至完全性感音神经性听力损失患者。所有患者均接受了单阶段手术,包括 CI、内淋巴囊手术和外侧半规管闭塞术。手术是在保守治疗失败后进行的。临床结果通过头晕障碍量表(DHI)和听力测试进行评估。分别在术前、术后 3 个月和 6 个月进行评估。为支持临床诊断,还进行了水肿序列核磁共振成像检查:结果:联合手术后,DHI测试的平均值从71分明显降低到30分。植入耳蜗后,单音节言语听力测试的平均结果为65分贝时65%。2名患者的残余听力在手术后得以保留:结论:外侧半规管闭塞术、内淋巴囊手术和人工耳蜗植入术相结合,是治疗单侧MD和中重度至完全感音神经性听力损失患者的一种高效、创伤小的治疗方法。
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来源期刊
Audiology and Neuro-Otology
Audiology and Neuro-Otology 医学-耳鼻喉科学
CiteScore
3.20
自引率
6.20%
发文量
35
审稿时长
>12 weeks
期刊介绍: ''Audiology and Neurotology'' provides a forum for the publication of the most-advanced and rigorous scientific research related to the basic science and clinical aspects of the auditory and vestibular system and diseases of the ear. This journal seeks submission of cutting edge research opening up new and innovative fields of study that may improve our understanding and treatment of patients with disorders of the auditory and vestibular systems, their central connections and their perception in the central nervous system. In addition to original papers the journal also offers invited review articles on current topics written by leading experts in the field. The journal is of primary importance for all scientists and practitioners interested in audiology, otology and neurotology, auditory neurosciences and related disciplines.
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