Journal of Otolaryngology and Ophthalmology of Shandong University ›› 2020, Vol. 34 ›› Issue (5): 46-50.doi: 10.6040/j.issn.1673-3770.1.2020.061

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Therapeutic effectiveness of 75 cases of retrolabyrinthine vestibular neurectomy for intractable Menieres disease

  

  • Received:2020-07-07 Published:2020-11-17

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Abstract: Objective To determine the therapeutic effectiveness of retrolabyrinthine vestibular neurectomy for intractable Menieres disease. Methods Clinical data of 75 patients with unilateral intractable Menieres disease who underwent retrolabyrinthine vestibular neurectomy were retrospectively investigated. Therapeutic effectiveness was analyzed, and the safety and reliability of the procedure was discussed. Results The mean duration of the disease was 53.11±43.87 months. Preoperative pure tone average of 500 Hz, 1 000 Hz, 2 000 Hz, and 4 000 Hz was(63.71±16.85)dB HL. Two cases were stage Ⅱ, 34 cases were stage Ⅲ, and 39 cases were stage Ⅳ. Two stage Ⅱ patients were recurrent cases after endolymphatic sac decompression surgery. Intracranial infection in 1 case(1.3%), cerebrospinal fluid leakage in 4 cases(5.3%), temporal facial nerve palsy in 1 case(1.3%), incision infection in 2 cases(2.6%), and fat liquefaction in 3 cases(3.9%)were observed postoperatively. There was no case of intracranial hemorrhage or total deafness. Therapeutic effectiveness for relieving vertigo was level A in 73 cases and level B in 2 cases. Conclusion The therapeutic effectiveness of retrolabyrinthine vestibular neurectomy for intractable Menieres disease is definite. Surgical risk and postoperative complications are controllable, and the quality of life can be significantly improved after surgery.

Key words: Menieres disease, Vertigo, Vestibular neurectomy, Hearing loss, Therapeutic effectiveness, Vestibular compensation

CLC Number: 

  • R764.33
[1] Jackler RK, Whinney D. A century of eighth nerve surgery [J]. Otol Neurotol,2001,22(3):401-416. doi:10.1097/00129492-200105000-00023
[2] 时海波, 殷善开. 前庭神经切断术治疗梅尼埃病[J]. 中国医学文摘(耳鼻咽喉科学),2008(5):266-267.
[3] Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menières disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc[J]. Otolaryngol Head Neck Surg,1995,113(3):181-185. doi:10.1016/S0194-5998(95)70102-8.
[4] Yates BJ, Bronstein AM. The effects of vestibular system lesions on autonomic regulation: observations, mechanisms, and clinical implications[J]. J Vestib Res, 2005, 15(3): 119-129.
[5] Tighilet B, Bordiga P, Cassel R, et al. Peripheral vestibular plasticity vs central compensation: evidence and questions[J]. J Neurol, 2019, 266(Suppl 1): 27-32. doi:10.1007/s00415-019-09388-9.
[6] Beraneck M, Idoux E. Reconsidering the role of neuronal intrinsic properties and neuromodulation in vestibular homeostasis[J]. Front Neurol, 2012, 3: 25. doi:10.3389/fneur.2012.00025.
[7] Lacour M, Helmchen C, Vidal PP. Vestibular compensation: the neuro-otologists best friend[J]. J Neurol, 2016, 263(Suppl 1): S54-S64. doi:10.1007/s00415-015-7903-4.
[8] Lacour M, Barthelemy J, Borel L, et al. Sensory strategies in human postural control before and after unilateral vestibular neurotomy[J]. Exp Brain Res, 1997, 115(2): 300-310. doi:10.1007/pl00005698.
[9] Arshad Q, Seemungal BM. Age-related vestibular loss: current understanding and future research directions[J]. Front Neurol, 2016, 7: 231. doi:10.3389/fneur.2016.00231.
[10] Noohi F, Kinnaird C, De Dios Y, et al. Deactivation of somatosensory and visual cortices during vestibular stimulation is associated with older age and poorer balance[J]. PLoS One, 2019, 14(9): e0221954. doi:10.1371/journal.pone.0221954.
[11] Chen BS, Roberts DS, Lekovic GP. Vestibular neurectomy for intractable Vertigo: case series and evaluation of role of endoscopic assistance in retrolabyrinthine craniotomy[J]. J Neurol Surg B Skull Base, 2019, 80(4): 357-363. doi:10.1055/s-0038-1670685.
[12] Kitahara T. Evidence of surgical treatments for intractable Menieres disease[J]. Auris Nasus Larynx, 2018, 45(3): 393-398. doi:10.1016/j.anl.2017.07.016.
[13] 于浩然, 杨军, 周欣. 梅尼埃病不同手术治疗方案的效果分析[J]. 临床耳鼻咽喉头颈外科杂志,2019,33(6):501-504. doi:10.13201/j.issn.1001-1781.2019.06.006. YU Haoran, YANG Jun, ZHOU Xin. The effect of surgical treatment on Menieres disease[J]. Journal of Clinical Otorhinolaryngology Head and Neck Surgery,2019,33(6):501-504. doi:10.13201/j.issn.1001-1781.2019.06.006.
[14] Lee HJ, Lee JM, Shim DB, et al. Is early progression to bilateral involvement in menières disease a poor prognostic indicator?[J]. And, 2019, 40(10): 1333-1338. doi:10.1097/MAO.0000000000002368.
[15] 李斐, 庄建华, 陈瑛, 等. 梅尼埃病不同听力分期中颈肌前庭诱发肌源性电位的差异[J]. 临床耳鼻咽喉头颈外科杂志, 2016(1): 9-12. doi:10.13201/j.issn.1001-1781.2016.01.003 LI Fei, ZHUANG Jianhua, CHEN Ying, et al. Difference of cervical vestibular evoked myogenic potentials in different audition stage of Ménière disease[J]. Journal of Clinical Otorhinolaryngology, 2016(1): 9-12. doi:10.13201/j.issn.1001-1781.2016.01.003.
[16] Kharkheli E, Japaridze S, Kevanishvili Z, et al. Correlation between vestibular evoked myogenic potentials and disease progression in ménières disease[J]. ORL J Otorhinolaryngol Relat Spec, 2019, 81(4): 193-201. doi:10.1159/000496088.
[17] Master AN, Flores JM, Gardner LG, et al. Anatomical Factors Influencing Selective Vestibular Neurectomy: A Comparison of Posterior Fossa Approaches[J]. J Neurol Surg B Skull Base, 2016,77(1):19-23. doi: 10.1055/s-0035-1556876.
[18] Kitamura K, Miyata M, Wanamaker HH, et al. Vestibular neurectomy: a histological and clinical study of results[J]. J Laryngol Otol,1996,110(3):211-215.doi: 10.1017/s0022215100133225.
[19] 赵志勇. 经迷路后入路和经枕下乙状窦后入路对桥小脑角显露程度和损伤程度的综合评价[D].兰州:兰州大学,2007.
[20] Alarcón AV, Hidalgo LO, Arévalo RJ, et al. Labyrinthectomy and vestibular neurectomy for intractable vertiginous symptoms[J]. Int Arch Otorhinolaryngol, 2017, 21(2): 184-190. doi:10.1055/s-0037-1599242.
[21] Eisenman DJ, Speers R, Telian SA. Labyrinthectomy versus vestibular neurectomy: long-term physiologic and clinical outcomes[J]. Otol Neurotol, 2001, 22(4): 539-548. doi:10.1097/00129492-200107000-00022.
[22] 赵毅涛, 杨铁毅, 张岩. 手术后切口脂肪液化防治的研究进展[J]. 医学综述, 2016, 22(1): 97-101. doi:10.3969/j.issn.1006-2084.2016.01.028. ZHAO Yitao, YANG Tieyi, ZHANG Yan. Research progress of treatment and prevention of postoperative fat liquefaction of the incision[J]. Medical Recapitulate, 2016, 22(1): 97-101. doi:10.3969/j.issn.1006-2084.2016.01.028.
[23] McElveen JT Jr, Shelton C, Hitselberger WE, et al. Retrolabyrinthine vestibular neurectomy: a reevaluation[J]. Laryngoscope, 1988, 98(5): 502-506. doi:10.1288/00005537-198805000-00005.
[24] Moody-Antonio S, House JW. Hearing outcome after concurrent endolymphatic shunt and vestibular nerve section[J]. Otol Neurotol, 2003, 24(3): 453-459. doi:10.1097/00129492-200305000-00016.
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