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PubMedDate not supplied

Viral culture and electron microscopy of ganglion cells in Meniere's disease and Bell's palsy.

Specimens of Scarpa's ganglion during vestibular neurectomy were obtained in 6 cases of Meniere's disease and specimens of geniculate ganglion in 2 cases of total facial nerve decompression and studied by tissue culture methods for detection of possible herpes and cytomegalovirus infection. In electron microscopy inclusions in the form of interwoven yarn-like structures, coarse aggregates of chromatin and light nuclear bodies were found in several vestibular ganglion cells. No typical herpes virus virions could be demonstrated. The culture for viruses all proved finally negative. At present there is no proof that viruses are present in Scarpa's or geniculate ganglions but the possibility remains that the inclusion bodies observed might be viruses inactivated inside the ganglion cells.

Cell Nucleus↗
PubMed1983

Endolymphatic mastoid shunt for treatment of Meniere's disease: a five year study.

The endolymphatic mastoid shunt seems to be an effective treatment for those patients whose Meniere's disease is refractory to medical and/or supportive treatment. This series is composed of 48 patients who were followed for up to 5 years postoperatively, with 1 year being the minimum follow-up period; 81% of these patients obtained a satisfactory relief of their vertigo. The morbidity of the procedure is low with no severe or total hearing loss reported in this series. Surgery should not be recommended until the symptoms have caused severe incapacitation; however, this delay must be tempered by the desire to operate while the hearing is still fluctuating. One of the most important factors in the surgical success may be the exact identification and exposure of the sac at the time of surgery, regardless of the specific shunt technique used. Shorter duration of symptoms and lack of fluctuant hearing loss may be preoperative factors which predict a less satisfactory surgical result. While the endolymphatic shunt procedure is effective in the majority of cases, the patient should be prepared for a secondary procedure if necessary.

Adult↗
PubMed1998

The non-specific effect of endolymphatic sac surgery in treatment of Meniere's disease: a prospective, randomized controlled study comparing "classic" endolymphatic sac surgery with the insertion of a ventilating tube in the tympanic membrane.

A prospective, randomized study was carried out comparing the effect of two surgical modalities in the treatment of patients with Meniere's disease: insertion of an endolymphatic sac shunt and insertion of a ventilating tube in the tympanic membrane. A total of 29 patients, 12 males and 17 females, age 27-71 years, were operated on in two ear, nose and throat (ENT) departments. Of these patients, 15 had an endolymphatic shunt inserted and 14 had a ventilating tube inserted in the tympanic membrane. Postoperative follow-up was carried out in the department in which the patients had not been operated. The severity of the disease was scored pre- and postoperatively, and the results evaluated under the guidelines of the Committee on Hearing and Equilibrium (1995) for the diagnosis and evaluation of therapy in Meniere's disease. The patients in both groups had a statistically significant reduction in dizzy spells, measured 6 and 12 months postoperatively, and there was no difference between the groups. The pathophysiological explanation for the reduction in dizzy spells in each of the treatment modalities is debatable and the effect is non-specific. The patients' hearing and tinnitus were statistically unaffected by the treatment in both groups, though 2 patients in the shunt group developed severe hearing loss (anacusis/70 dB).

Adult↗
PubMed2004

[Clinical value of vestibular evoked myogenic potentials in saccular dysfunction in Meniere's disease: a case report].

Sound-induced vestibular evoked myogenic potentials (VEMP) on the surface of the sternocleidomastoid muscle constitute the basis of the saccular function test. In order to assess the saccular function, VEMP test was performed in a patient having unilateral Meniere's disease with profound sensorineural hearing loss in the contralateral ear. The saccular response was absent on the affected side with a normal caloric response. However, VEMP response was normal in the contralateral ear with profound sensorineural hearing loss and canal paresis. There may be saccular dysfunction in Meniere's disease.

Adult↗
PubMed1977

The surgical anatomy of the endolymphatic sac.

The endolymphatic sac (ELS) and vestibular aqueduct (VA), which play a notable role in the pathogenesis of endolymphatic hydrops and Meniere disease, were identified in all anatomic and tomographic materials. More than 100 temporal bones were used for microdissection, tomography, and plastic molds. Normal subjects and Meniere disease patients were studied tomographically (N = 63) and observed during ELS surgery (N=49). In Meniere disease there is, with increassing duration of diseases, a decrease in the periaqueductal and opercular air cell pneumatization, with a concomitant shorter and straighter VA. This correlates with a decreased ELS luminal patency, and a more inferiorly positioned ELS. These factors help to explain both the difficulties of visualizing the VA by tomography in Meniere disease as well as the occasional difficulties reported by others in satisfactorily identifying the ELS at sac surgery. All observations are made from the surgeon's viewpoint to enhance clinical identification of the ELS.

Adult↗
PubMed2005

[Intratympanic dexamethasone injections for intractable Meniere's disease].

OBJECTIVE: To investigate the efficacy of intratympanic dexamethasone injections (IDI) and intermittent pressure (IP) for 13 patients with intractable Meniere's disease (MD). METHOD: Dexamethasone (5 g/L) was injected into the middle ear. The injection was repeated the next day and weekly for 3 weeks. Together with tympanic intermittent pressure (IP). RESULT: The 13 patients was followed up for 2-5 years. Complete relief vertigo was maintained in 9 cases,improved in 3 cases. The injection was repeated in 1 patient with recurrent vertigo and total control of vertigo was obtained. Tinnitus disappeared in 5 cases, reduced in 3 case, unchanged in 5 cases. Hearing was improved in 9 cases, unchanged in 4 cases. CONCLUSION: IDI and IP are effective for intractable MD. The benefits of IDI and IP are easy application for doctors and reasonable cost which can be accepted by patients easily.

Adult↗
PubMed1985

Endolymphatic sac surgery for Meniere's disease: a composite study of 339 cases.

This paper analyzes 339 consecutively performed endolymphatic mastoid sac shunts. Regardless of the method used, vertigo was controlled and hearing either improved or stabilized in approximately 70% of the cases. Overall, vertigo was controlled in approximately 80% of the cases. Similar results were obtained in cases of Meniere's syndrome and vestibular Meniere's disease. It is suggested here that, regardless of the method employed, there remains a high likelihood that the symptoms will recur, and the question is raised as to whether sac surgery may merely induce a temporary remission of the disease process. Consequently, it is hereby proposed that there is a need to devise a method to permanently drain the endolymph in order to more effectively control the disease on a permanent basis. Until this is achieved, however, sac surgery would appear to be the most appropriate surgical treatment for Meniere's disease.

Adolescent↗