We have located links that may give you full text access.
Pathology as it relates to ear surgery. IV. Surgery of Menière's disease.
Journal of Laryngology and Otology 1984 Februrary
Conservative shunting procedures, i.e. ESS, ultrasonic irradiation and cryosurgery, are based on the assumption that there is increased volume and/or pressure of endolymph in Menière's disease. Since there is no reliable clinical test to detect endolymphatic hydrops, shunting procedures on cases without hydrops are doomed to failure. Surgery on the endolymphatic sac was not associated with fibrosis or obliteration of its lumen. Silastic shunt tubes were well tolerated by the body, and the shunt between the sac and the subarachnoid space seemed to remain open. The results of experimental surgery on the endolymphatic sac and its applicability to humans should be revised. Temporary improvement of Menière's symptom-complex may be expected from any surgical procedure on the membranous labyrinth, even in cases without endolymphatic hydrops. Post-operative serous labyrinthitis with associated biochemical changes is the cause of this improvement. The success of shunting procedures cannot be judged histologically by the position of Reissner's membrane. This membrane acts like varicose veins: once dilated, always dilated. Ultrasonic irradiation and cryosurgery of the labyrinth result in limited degenerative changes close to the site of probe application. Degenerated intact membranous walls may act as an internal otic-perotic shunt and may result in symptomatic improvement in Menière's disease. The idea of selective vestibular neurectomy and internal shunting procedures, i.e. without drainage of endolymph to the outside (mastoid) or to the inside (CSF), should be developed further. Recurrence of symptoms following shunting procedures may be due to failure of the shunt, or to the presence of endolymphatic hydrops in the non-operated ear. MF vestibular neurectomy results in complete denervation of the vestibular end-organs, without effect on the cochlea or facial nerve. Excision of Scarpa's ganglion causes retrograde degeneration in the proximal stump of the vestibular nerve, most probably to the level of the brain-stem. Recurrence of dizziness following TC labyrinthectomy is most commonly due to inadequate removal of the vestibular end-organs. The high regenerative capacity of the vestibular nerve is evidenced by the formation of traumatic neuromas in the vestibule following TC labyrinthectomy. Whether these neuromas produce symptoms is unknown. Persistent cochlear hydrops occurs following TC labyrinthectomy and TL vestibular neurectomy owing to obstruction in the hook region of the cochlea and in the ductus reuniens. This may result in persistent tinnitus and feeling of pressure in the ear.
Full text links
Related Resources
Trending Papers
Challenges in Septic Shock: From New Hemodynamics to Blood Purification Therapies.Journal of Personalized Medicine 2024 Februrary 4
Molecular Targets of Novel Therapeutics for Diabetic Kidney Disease: A New Era of Nephroprotection.International Journal of Molecular Sciences 2024 April 4
The 'Ten Commandments' for the 2023 European Society of Cardiology guidelines for the management of endocarditis.European Heart Journal 2024 April 18
A Guide to the Use of Vasopressors and Inotropes for Patients in Shock.Journal of Intensive Care Medicine 2024 April 14
Diagnosis and Management of Cardiac Sarcoidosis: A Scientific Statement From the American Heart Association.Circulation 2024 April 19
Essential thrombocythaemia: A contemporary approach with new drugs on the horizon.British Journal of Haematology 2024 April 9
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app
All material on this website is protected by copyright, Copyright © 1994-2024 by WebMD LLC.
This website also contains material copyrighted by 3rd parties.
By using this service, you agree to our terms of use and privacy policy.
Your Privacy Choices
You can now claim free CME credits for this literature searchClaim now
Get seemless 1-tap access through your institution/university
For the best experience, use the Read mobile app