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Results for “Endolymphatic Shunt”

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At least 19 recordsLinked to original sources
PubMed1988

Management of vertigo in patients with syphilis: is endolymphatic shunt surgery appropriate?

Endolymphatic shunt surgery has been suggested as a means to relieve vertigo caused by syphilis in patients unresponsive to conventional medical therapy. We reviewed results of endolymphatic shunt surgery on vertigo and hearing in six patients with syphilis. We found no relief of vertigo in four patients who qualified for this measure and no improvement in hearing. Histologic review of temporal bones from three patients with syphilitic hydrops revealed syphilitic involvement of the endolymphatic duct system. This may explain why endolymphatic shunt surgery may not be beneficial.

Ear Diseases↗
PubMed2003

Hearing outcome after concurrent endolymphatic shunt and vestibular nerve section.

OBJECTIVE: To determine if endolymphatic shunt surgery concurrent with vestibular nerve section improves hearing outcome compared with vestibular nerve section alone. STUDY DESIGN: Retrospective observational study with cross-sectional survey. SETTING: Tertiary otologic private practice. PATIENTS: Thirty-five patients who underwent vestibular nerve section and endolymphatic shunt surgery and 17 patients who had vestibular nerve section alone between 1985 and 2000. METHODS: Chart review and correspondence for audiogram results and survey. MAIN OUTCOME MEASURES: Hearing at last follow-up. Hearing Handicap Inventory, Dizziness Handicap Inventory, Tinnitus Handicap Inventory, and SF-36. RESULTS: Eight patients in the vestibular nerve section and 15 in the vestibular nerve section and endolymphatic shunt surgery group had an audiogram at more than 16 months after surgery available for review. In the vestibular nerve section group, three patients had same hearing whereas five were worse. In the vestibular nerve section and endolymphatic shunt surgery group, 2 patients showed improvement, 2 were the same, and 11 were worse. There was no significant difference in the change from preoperative pure tone average or Word Discrimination Score to postoperative levels between the surgical groups. Eighteen patients had serviceable hearing preoperatively. Five of 8 in the vestibular nerve section and 4 of 10 in the vestibular nerve section and endolymphatic shunt surgery groups maintained serviceable hearing postoperatively. Of the 52 patients, 33 responded to the survey (63%). There were no significant differences between the groups for Dizziness Handicap Inventory, Hearing Handicap Inventory, Tinnitus Handicap Inventory, or SF-36, suggesting that patient-oriented outcomes are the same in both groups. CONCLUSIONS: Concurrent endolymphatic shunt surgery and vestibular nerve section does not improve hearing or tinnitus outcome over vestibular nerve section alone.

Audiometry, Pure-Tone↗
PubMed1996

Endolymphatic system shunting: a long-term profile of the Denver Inner Ear Shunt.

Endolymphatic system surgery for Meniere's disease, particularly endolymphatic shunting, remains controversial. In 1988, we presented our findings on the efficacy of the Denver Inner Ear Shunt in 100 patients. These data were accumulated in the short term. The purpose of this article is to review the long-term results of our endolymphatic shunt procedure, highlighting the population of Denver Inner Ear Shunt recipients. Results were analyzed according to both 1972 and 1985 AAO-HNS criteria. We seek corroboration or refutation of our preliminary conclusion that (a) endolymphatic shunt surgery has little efficacy and that (b) the Denver valve does not appear to offer any advantage in this regard.

Adolescent↗
PubMed2002

Medical devices; ear, nose and throat devices; reclassification of the endolymphatic shunt tube with valve. Final rule.

The Food and Drug Administration (FDA) is reclassifying the endolymphatic shunt tube with valve from class III (premarket approval) into class II (special controls). The device is intended to be implanted in the inner ear to relieve the symptoms of vertigo and hearing loss due to endolymphatic hydrops (increase in endolymphatic fluid) of Meniere's disease. FDA is also identifying the guidance document entitled "Class II Special Controls Guidance Document: Endolymphatic Shunt Tube With Valve; Guidance for Industry and FDA" (the guidance) as the special control that the agency believes will reasonably ensure the safety and effectiveness of the device. This reclassification is based on new information submitted in are classification petition by E. Benson Hood Laboratories, Inc. (Hood Laboratories). FDA is taking this action under the Federal Food, Drug, and Cosmetic Act (the act), as amended by the Medical Device Amendments of 1976, the Safe Medical Devices Act of 1990, and the Food and Drug Administration Modernization Act of 1997. Elsewhere in this issue of the Federal Register, FDA is publishing a notice announcing the guidance.

Device Approval↗
PubMed1990

Temporal bone findings in a case of bilateral Menière's disease treated by parenteral streptomycin and endolymphatic shunt.

A patient with bilateral Menière's disease who had progressive hearing loss and intractable vertigo was treated at ages 60 and 62 with parenteral streptomycin to ablate vestibular function, and at age 74 by a left endolymphatic shunt procedure. He was confined to a wheelchair because of ataxia from age 75 until the time of his death at age 81. Both temporal bones show congenitally hypoplastic endolymphatic sacs and severe endolymphatic hydrops consistent with Meniere's disease. There was atrophy of the striae vasculares and loss of cochlear neurons consistent with presbycusis. A loss of hair cells in the cristae and saccules was consistent with streptomycin ototoxicity. In the left ear the Silastic strip that was intended to function as an endolymphatic shunt into the mastoid lies encased in fibrous tissue and failed by 4.5 mm to reach the hypoplastic endolymphatic sac.

Ataxia↗
PubMed1983

Endolymphatic shunt: an evaluation by test results.

Failure in the endolymphatic shunt operation for Meniere's disease is reportedly 30% or more. The fact that many patients have relief from their symptoms following this surgery offers validity to the procedure. Pure tone audiograms and sinusoidal harmonic acceleration (rotary chair or rotary test, RT) were used concurrently to evaluate end-results of this operation in 31 patients with Meniere's disease. RT shows parameters of phase and labyrinthine preponderance (LP) calculated by a computer. LP was determined by separately integrating the total slow-phase output of the vestibulo-ocular reflex (VOR) to the left and right and converting the differences to percentages. Irritative and destructive lesions in Meniere's disease may be accurately resolved using this technique. It was not possible to predict with any accuracy the irritative-destructive parameter using pure tone audiometry. Patients who had irritative lesions fared better with the shunt operation. An analysis of these patients is made with RT.

Audiometry, Pure-Tone↗
PubMed1985

Cochlear endolymphatic shunt for Meniere's disease.

We have now performed the cochlear endolymphatic shunt operation for Meniere's disease on 102 ears and have follow-up data on ninety cases. In this fourth report of results of the procedure, we show that after follow-up ranging from one month to six years (average 22.3 months), definitive vertigo was relieved in 72% of the cases and that hearing at the time of most recent audiogram (average 12.6 months postoperatively) was worse (AAO criteria) in 45% of the cases.

Adolescent↗
PubMed1988

A critical comparison of results of endolymphatic subarachnoid shunt and endolymphatic sac incision operations.

Detailed information was obtained by questionnaires, office visits, chart reviews, and telephone calls from 171 of 179 consecutive patients who underwent endolymphatic sac surgery between 1976 and 1986. A comparison of surgical results was made. For patients followed more than 24 months, complete control of vertigo was obtained in 40 of 68 patients (59%) by endolymphatic subarachnoid shunt and in 27 of 60 patients (45%) who underwent a variety of sac incision operations. This difference achieved borderline statistical significance (p less than or equal to 0.057). Profound or total hearing loss occurred in 8 patients (4.3%), 6 of whom had sac mastoid procedures. The percentage of patients indicating an absence of disability improved in both groups dramatically following surgery.

Persons with Disabilities↗
PubMed1983

A ten year statistical follow-up of 245 consecutive cases of endolymphatic shunt and decompression with 328 consecutive cases of labyrinthectomy.

The etiology of Meniere's disease is unknown and the treatment is empirical and at best controversial. The goals of treatment are hearing preservation and the control of vertigo. Between 1956 and 1971, a total of 5,208 cases of Meniere's disease was seen. Medical treatment was effective in 4,530 cases (87%), while surgery was employed in 677 cases (13%). The surgical procedures were divided into 1. a conservative group where useful hearing was still present and 2. a destructive group where no useful hearing existed. The conservation operation employed was a procedure on the endolymphatic sac, while the destructive procedure was a labyrinthectomy. In a small series of cases where these procedures failed to control the vertigo, a middle cranial fossa vestibular nerve section was done. This review of our experience summarizes the efficacy of each procedure in reaching the stated goals of hearing preservation and the control of vertigo.

Ear, Inner↗
PubMed1983

Revision of previous stapedectomy, tympanoplasty, mastoidectomy, or endolymphatic shunt.

I have reviewed a group of otologic patients who represent controversial problems in management. Decisions for revisional otologic surgery must be based on each patient's individual findings. Statistical reviews are of little help in deciding which patient will benefit. Physicians managing patients with poor results after surgery for hearing, infection, or vertigo must obtain accurate audiologic, electronystagmographic, and laboratory data before deciding on revisional surgery. The overall interests of the patient are sometimes best served by avoiding further surgical insults to the ear.

Adolescent↗