18,19] When intense attacks are frequent, more invasive procedures such as instillation of gentamicin or steroids via intratympanic injection or a grommet may be considered or, very rarely, vestibular nerve section or labyrinthectomy
Another procedure, a labyrinthectomy
, calls for removing the balance portion of the inner ear; however, this removes both the balance and hearing function from the affected ear, and is performed only if the patient already has near-total or total hearing loss in that ear.
Successful electrode insertion has been achieved by drilling out the obliterated portion of the basal turn (2) or by performing a partial labyrinthectomy
to gain access to the round window and allow electrode insertion (7).
Surgical intervention--including installation of an endolymphatic shunt, labyrinthectomy
, or vestibular neurectomy (16) --or transtympanic injections of gentamicin (17) are options in severe cases.
in patients with severe Meniere's disease uncontrolled by drugs and lifestyle changes and where hearing is no longer adequate, a labyrinthectomy
has a 95 per cent success rate in eliminating major spells.
, the removal of the membranous labyrinth, is an irreversible procedure that is often successful in eliminating the dizziness associated with Meniere's disease.
and eighth nerve section are procedures in which the balance and hearing mechanism in the inner ear are destroyed on one side.
One of them, examined on the same day as his MRI, had undergone labyrinthectomy
on the side ipsilateral to reported findings of mastoiditis.
The 20 patients with recurrence required additional gentamicin injections, plus vestibular neurectomy in 2 of them and transmastoid labyrinthectomy
for persistent vertigo attacks in 1.
Note that for states that use the CPT coding system, counts include all procedures that involved a mastoidectomy, including complete mastoidectomy, modified radical mastoidectomy, radical mastoidectomy, transmastoid antrotomy, petrous apicectomy including radical mastoidectomy, all revision mastoidectomy procedures, tympanoplasty with antrotomy or mastoidectomy, tympanoplasty with mastoidectomy, mastoid obliteration, and labyrinthectomy
is a last resort procedure to treat severe vertigo, usually in patients with Meniere disease who have failed all conservative medical and surgical means of treatment, especially when the disease is predominantly unilateral.
The type of surgical procedures included myringoplasty, tympanoplasty, tympano-ossiculoplasty, tympanomastoidectomy, perilymph fistula repair, and labyrinthectomy