Chemical cochleovestibular deafferentation was performed on 21 individuals suffering from disabling vertigo caused by unilateral Meniere's disease. Patients ranged in age from 31 to 60 years, with a mean age of 47.4. The duration of the disease spanned 3 to 14 years, mean duration being 5.8 years. Subjects displayed pure-tone thresholds higher than 50 dB HL in the affected ear and better than 25 dB HL in the contralateral ear. The frequency of vertigo, evaluated during the 6 months before surgery, ranged from 1 crisis a month to 2 a week; mean duration of crises was 1 to 6 hours. Medical treatment had failed in all cases. The surgical procedure consisted of stapedectomy, deposition of several crystals of NaCl in the vestibule, and sealing of the oval window with a vein graft. Postoperative recovery was rapid, allowing patients to be discharged 4 to 6 days after surgery. All subjects reported complete relief of vertigo. Tinnitus disappeared in 47.6% of the subjects, was reduced in 33.3% and unchanged in 19.1%. Most patients complaining of aural fullness preoperatively reported relief of this symptom after surgery. The outcomes of the present study indicate that NaCl deposition into the vestibule is a simple, safe, and effective technique of cochleovestibular deafferentation.
NaCl deposition in the vestibule: a simple, safe, and effective method of cochleovestibular deafferentation
COLLETTI, Vittorio;
1989-01-01
Abstract
Chemical cochleovestibular deafferentation was performed on 21 individuals suffering from disabling vertigo caused by unilateral Meniere's disease. Patients ranged in age from 31 to 60 years, with a mean age of 47.4. The duration of the disease spanned 3 to 14 years, mean duration being 5.8 years. Subjects displayed pure-tone thresholds higher than 50 dB HL in the affected ear and better than 25 dB HL in the contralateral ear. The frequency of vertigo, evaluated during the 6 months before surgery, ranged from 1 crisis a month to 2 a week; mean duration of crises was 1 to 6 hours. Medical treatment had failed in all cases. The surgical procedure consisted of stapedectomy, deposition of several crystals of NaCl in the vestibule, and sealing of the oval window with a vein graft. Postoperative recovery was rapid, allowing patients to be discharged 4 to 6 days after surgery. All subjects reported complete relief of vertigo. Tinnitus disappeared in 47.6% of the subjects, was reduced in 33.3% and unchanged in 19.1%. Most patients complaining of aural fullness preoperatively reported relief of this symptom after surgery. The outcomes of the present study indicate that NaCl deposition into the vestibule is a simple, safe, and effective technique of cochleovestibular deafferentation.
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