Hostname: page-component-8448b6f56d-cfpbc Total loading time: 0 Render date: 2024-04-25T01:05:34.913Z Has data issue: false hasContentIssue false
  • English
  • Français

Surgery for vertigo: 10-year audit from a contemporary vertigo clinic

Published online by Cambridge University Press:  11 December 2015

U Patnaik ,
A Srivastava ,
K Sikka  and
A Thakar
U Patnaik
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India Department of Otolaryngology – Head and Neck Surgery, Army Hospital Research and Referral, New Delhi, India
A Srivastava
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
K Sikka
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
A Thakar*
Affiliation:
Department of Otolaryngology – Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi, India
*
Address for correspondence: Prof Alok Thakar, Department of Otolaryngology – Head and Neck Surgery, All India Institute of Medical Sciences, New Delhi 110029, India E-mail: drathakar@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

To present the profile of patients undergoing surgical treatment for vertigo at a contemporary institutional vertigo clinic.

Study design:

A retrospective analysis of clinical charts.

Methods:

The charts of 1060 patients, referred to an institutional vertigo clinic from January 2003 to December 2012, were studied. The clinical profile and long-term outcomes of patients who underwent surgery were analysed.

Results:

Of 1060 patients, 12 (1.13 per cent) were managed surgically. Of these, disease-modifying surgical procedures included perilymphatic fistula repair (n = 7) and microvascular decompression of the vestibular nerve (n = 1). Labyrinth destructive procedures included transmastoid labyrinthectomy (n = 2) and labyrinthectomy with vestibular nerve section (n = 1). One patient with vestibular schwannoma underwent both a disease-modifying and destructive procedure (translabyrinthine excision). All patients achieved excellent vertigo control, classified as per the American Academy of Otolaryngology – Head and Neck Surgery 1995 criteria.

Conclusion:

With the advent of intratympanic treatments, surgical treatments for vertigo have become further limited. However, surgery with directed intent, in select patients, can give excellent results.

Keywords

VertigoSurgical Procedures, OperativePatient Outcome AssessmentModern Medicine
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 12 , December 2015 , pp. 1182 - 1187
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Sismanis, A. Surgical management of common peripheral vestibular diseases. Curr Opin Otolaryngol Head Neck Surg 2010;18:431–5CrossRefGoogle ScholarPubMed
2Lee, L, Pensak, ML. Contemporary role of endolymphatic mastoid shunt surgery in the era of transtympanic perfusion strategies. Ann Otol Rhinol Laryngol 2008;117:871–5CrossRefGoogle ScholarPubMed
3Ghossaini, SN, Wazen, JJ. An update on the surgical treatment of Meniere's diseases. J Am Acad Audiol 2006;17:38–44Google ScholarPubMed
4Kaylie, DM, Jackson, CG, Gardner, EK. Surgical management of Meniere's disease in the era of gentamicin. Otolaryngol Head Neck Surg 2005;132:443–50CrossRefGoogle ScholarPubMed
5American Academy of Otolaryngology – Head and Neck Foundation. Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menière's disease. Otolaryngol Head Neck Surg 1995;113:181–5CrossRefGoogle Scholar
6Derebery, MJ, Fischer, LM, Berliner, K, Chung, J, Green, K. Outcomes of endolymphatic shunt surgery for Meniere's disease: comparison with intratympanic gentamicin on vertigo control and hearing loss. Otol Neurotol 2010;31:649–55CrossRefGoogle ScholarPubMed
7Teufert, KB, Doherty, J. Endolymphatic sac shunt, labyrinthectomy, and vestibular nerve section in Meniere's disease. Otolaryngol Clin North Am 2010;43:1091–111CrossRefGoogle ScholarPubMed
8Yu, MS, Lee, KS, Chung, JW. Long-term results of endolymphatic mastoid shunt surgery in patients with intractable Meniere's disease. Otolaryngol Head Neck Surg 2009;141:237–42CrossRefGoogle ScholarPubMed
9Semaan, MT, Megerian, CA. Contemporary perspectives on the pathophysiology of Meniere's disease: implications for treatment. Curr Opin Otolaryngol Head Neck Surg 2010;18:392–8CrossRefGoogle ScholarPubMed
10Yap, L, Pothula, VB, Lesser, T. Microvascular decompression of cochleovestibular nerve. Eur Arch Otorhinolaryngol 2008;265:861–9CrossRefGoogle ScholarPubMed
11Paradis, J, Hu, A, Parnes, LS. Endolymphatic sac surgery versus intratympanic gentamicin for the treatment of intractable Meniere's disease: a retrospective review with survey. Otol Neurotol 2013;34:1434–7CrossRefGoogle ScholarPubMed
12Albera, R, Canale, A, Parandero, F, Ducati, A, Lanotte, M. Surgical indication in Meniere's disease therapy: clinical and epidemiological aspects. Eur Arch Otorhinolaryngol 2011;268:967–72CrossRefGoogle ScholarPubMed
13Casani, AP, Cerchiai, N, Navari, E, Dallan, I, Piaggi, P, Sellari-Franceschini, S. Intratympanic gentamicin for Meniere's disease: short- and long-term follow-up of two regimens of treatment. Otolaryngol Head Neck Surg 2014;150:847–52CrossRefGoogle Scholar
14Shea, PF, Richey, PA, Wan, JY, Stevens, SR. Hearing results and quality of life after streptomycin/dexamethasone perfusion for Meniere's disease. Laryngoscope 2012;122:204–11CrossRefGoogle ScholarPubMed
15Cohen-Kerem, R, Kisilevsky, V, Einarson, TR, Kozer, E, Koren, G, Rutka, JA. Intratympanic gentamicin for Meniere's disease: a meta-analysis. Laryngoscope 2004;114:2085–91CrossRefGoogle ScholarPubMed
16Chia, SH, Gamst, AC, Anderson, JP, Harris, JP. Intratympanic gentamicin therapy for Meniere's disease: a meta-analysis. Otol Neurotol 2004;25:544–52CrossRefGoogle ScholarPubMed
17Casani, AP, Piaggi, P, Cerchiai, N, Seccia, V, Franceschini, SS, Dallan, I. Intratympanic treatment of intractable unilateral Meniere disease: gentamicin or dexamethasone? A randomized controlled trial. Otolaryngol Head Neck Surg 2012;146:430–7CrossRefGoogle ScholarPubMed
18Sajjadi, H, Paparella, MM. Meniere's disease. Lancet 2008;372:406–14CrossRefGoogle ScholarPubMed
19Nguyen, KD, Minor, LB, Santina, CC, Carey, JP. Vestibular function and vertigo control after intratympanic gentamicin for Meniere's disease. Audiol Neurotol 2009;14:361–72CrossRefGoogle ScholarPubMed
20Okuda, T, Sugahara, K, Shimogori, H, Yamashita, H. Inner ear changes with intracochlear gentamicin administration in guinea pigs. Laryngoscope 2004;114:694–7CrossRefGoogle ScholarPubMed
21Harner, SG, Driscoll, CL, Facer, GW, Beatty, CW, McDonald, TJ. Long-term follow-up of transtympanic gentamicin for Meniere's syndrome. Otol Neurotol 2001;22:210–14CrossRefGoogle ScholarPubMed
22Schuknecht, HF. Ablation therapy for the relief of Ménière's disease. Laryngoscope 1956;66:859–70CrossRefGoogle ScholarPubMed
23Cawthorne, T. Membranous labyrinthectomy via the oval window for Ménière's disease. J Laryngol Otol 1957;71:524–7CrossRefGoogle ScholarPubMed
24Giannuzzi, AL, Merkus, P, Falcioni, M. The use of intratympanic gentamicin in patients with vestibular schwannoma and disabling vertigo. Otol Neurotol 2013;34:1096–8CrossRefGoogle ScholarPubMed