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[PMID]:27525624
[Au] Autor:Liu IY; Sepahdari AR; Ishiyama G; Ishiyama A
[Ad] Endereço:*Department of Head & Neck Surgery†Department of Radiology‡Department of Neurology, David Geffen School of Medicine at UCLA, Los Angeles, California.
[Ti] Título:High Resolution MRI Shows Presence of Endolymphatic Hydrops in Patients Still Symptomatic After Endolymphatic Shunt Surgery.
[So] Source:Otol Neurotol;37(8):1128-30, 2016 Sep.
[Is] ISSN:1537-4505
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Endolymphatic hydrops has been well described in patients with Ménière's syndrome; however, causation has not been established. Decompression of the endolymphatic sac has been proposed as a means to relieve hydrops and improve vertigo symptoms, but the efficacy of the surgery is debated. Until recently, there have been few objective measures of efficacy other than patients' subjective symptoms. Recent archival human temporal bone studies have shown that patients continue to have hydrops after shunt surgery. We propose using high-resolution magnetic resonance imaging (MRI) to determine the efficacy of endolymphatic shunt surgery (ELS) in patients who continue to experience vertigo. PATIENTS: Four patients presented with continued vertigo after ELS. INTERVENTIONS: Magnetic resonance imaging sequences included "cisternographic" three-dimensional T2, and delayed intravenous-enhanced three-dimensional fluid-attenuation inversion recovery (DIVE-3D-FLAIR) sequences, performed with 2350 ms (bright perilymph) and 2050 ms (bright endolymph) inversion times. The bright endolymph images were subtracted from bright perilymph images to create a composite image with bright perilymph, dark endolymph, and intermediate bone signals. MAIN OUTCOME MEASURES: MRI finding of endolymphatic hydrops. RESULTS: In all five affected ears in four patients who continued to experience severe vertigo, hydrops was found on high resolution MRI on the operated ear. The appearance on MRI was no different than in patients with endolymphatic hydrops (EH) who have not had surgery. CONCLUSIONS: The present study demonstrates the persistence of endolymphatic hydrops in patients who have failed ELS. Future studies evaluating for the presence or absence of endolymphatic hydrops in patients who claim to obtain relief from ELS.
[Mh] Termos MeSH primário: Hidropisia Endolinfática/cirurgia
Anastomose Endolinfática
Falha de Tratamento
[Mh] Termos MeSH secundário: Hidropisia Endolinfática/etiologia
Hidropisia Endolinfática/patologia
Feminino
Seres Humanos
Imagem por Ressonância Magnética
Masculino
Doença de Meniere/complicações
Meia-Idade
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170920
[Lr] Data última revisão:
170920
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:160816
[St] Status:MEDLINE
[do] DOI:10.1097/MAO.0000000000001144


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[PMID]:25488280
[Au] Autor:Albu S; Babighian G; Amadori M; Trabalzini F
[Ad] Endereço:II-nd Department of Otolaryngology, Iuliu Hatieganu University of Medicine and Pharmacy Cluj-Napoca, Str. Republicii nr. 18, 400015, Cluj-Napoca, Romania. silviualbu63@gmail.com.
[Ti] Título:Endolymphatic sac surgery versus tenotomy of the stapedius and tensor tympani muscles in the management of patients with unilateral definite Meniere's disease.
[So] Source:Eur Arch Otorhinolaryngol;272(12):3645-50, 2015 Dec.
[Is] ISSN:1434-4726
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:This study aims to compare the outcomes of patients with Meniere's disease submitted to either endolymphatic mastoid shunt (ES) or tenotomy of the stapedius and tensor tympani muscles (TSTM). This is a retrospective chart review of patients treated with ES or TSTM between 2000 and 2010 and followed up for at least 12 months. The main outcomes were represented by: (1) vertigo class, hearing stage and functional level according to the American Academy of Otolaryngology-Head and Neck Surgery criteria; (2) adjustment of dizziness handicap inventory (DHI) and (3) complete and substantial vertigo control using the Kaplan-Meier survival method. Sixty-three patients met the inclusion criteria: 34 underwent ES and 29 TSTM. The baseline demographic characteristics, the hearing stage, the functional level, the DHI and hearing levels were not different between the two groups. No significant difference in vertigo class was demonstrated: 66 % of TSTM patients attained class A compared to 44 % in the ES group (p = 0.14). Kaplan-Meier survival curves specific to class A showed significant differences, favoring TSTM (log-rank test, p = 0.022). TSTM patients demonstrated significantly improved functional level (p = 0.0004) and improved DHI scores (p = 0.001). Eight ES patients (25 %) demanded a second surgical attempt compared to none in the TSTM. Aural fullness was significantly improved in TSTM group (p = 0.01), while the difference in tinnitus improvement was non-significant. Hearing preservation was significantly better in TSTM group (p = 0.001). TSTM is a safe surgical procedure, with significant vertigo control rates, and important hearing preservation rates. More patients and longer follow-up are needed to support our preliminary findings.
[Mh] Termos MeSH primário: Saco Endolinfático/cirurgia
Anastomose Endolinfática
Doença de Meniere
Estapédio/cirurgia
Tenotomia
Tensor de Tímpano/cirurgia
[Mh] Termos MeSH secundário: Adulto
Pesquisa Comparativa da Efetividade
Descompressão Cirúrgica/métodos
Gerenciamento Clínico
Saco Endolinfático/patologia
Anastomose Endolinfática/efeitos adversos
Anastomose Endolinfática/métodos
Feminino
Testes Auditivos/métodos
Seres Humanos
Estimativa de Kaplan-Meier
Masculino
Doença de Meniere/patologia
Doença de Meniere/fisiopatologia
Doença de Meniere/cirurgia
Meia-Idade
Avaliação de Resultados (Cuidados de Saúde)
Estudos Retrospectivos
Estapédio/patologia
Tenotomia/efeitos adversos
Tenotomia/métodos
Tensor de Tímpano/patologia
Vertigem/etiologia
Vertigem/cirurgia
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1606
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:141210
[St] Status:MEDLINE
[do] DOI:10.1007/s00405-014-3428-1


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[PMID]:25057891
[Au] Autor:Basura GJ; Lin GC; Telian SA
[Ad] Endereço:Division of Otology/Neurotology, Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor.
[Ti] Título:Comparison of second-echelon treatments for Ménière's disease.
[So] Source:JAMA Otolaryngol Head Neck Surg;140(8):754-61, 2014 Aug.
[Is] ISSN:2168-619X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:IMPORTANCE: To compare the efficacy of treatments commonly offered to patients with Ménière's disease who fail conservative medical therapy including diuretics and a sodium-restricted diet. OBJECTIVES: This study compared three second-echelon treatments: the Meniett device, endolymphatic sac decompression, and intratympanic gentamicin injections to determine their comparative effectiveness and capacity to mitigate against the necessity of a surgical labyrinthectomy. DESIGN, SETTING, AND PARTICIPANTS: Retrospective observational study at an academic tertiary care center. Patients with Ménière's disease who failed primary medical management were evaluated after treatment with a Meniett device (n=20), endolymphatic sac decompression (n=23) or intratympanic gentamicin injections (n=17). Cases were included if auditory and vertigo control data were available before and a minimum of two years after treatment, in patients without previous otologic surgery or intratympanic injections. Average age ranged from 54 to 75 years. INTERVENTIONS: Use of the Meniett device, endolymphatic sac shunt decompression surgery or intratympanic gentamicin injections using variable doses and injection schedules. MAIN OUTCOMES AND MEASURES: Proportion of patients with vertigo control and hearing preservation by a modified version of the AAO-HNS criteria after second-echelon treatment, thus not requiring definitive labyrinthectomy. RESULTS: Despite endolymphatic sac surgery demonstrating a longer duration (61 months) prior to labyrinthectomy, no differences were found between the 3 treatment options in terms of patients going on to definitive labyrinthectomy or in the number of months of symptom relief following treatment. There was also no difference in residual auditory perception across the 3 groups. CONCLUSIONS AND RELEVANCE: No significant therapeutic differences were found between the studied second-echelon treatments for symptom relief of Ménière's disease.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Anastomose Endolinfática/métodos
Doença de Meniere/terapia
[Mh] Termos MeSH secundário: Idoso
Descompressão Cirúrgica/instrumentação
Descompressão Cirúrgica/métodos
Dieta Hipossódica
Diuréticos/administração & dosagem
Feminino
Gentamicinas/administração & dosagem
Seres Humanos
Injeções Intralesionais
Doença de Meniere/cirurgia
Meia-Idade
Retratamento
Estudos Retrospectivos
Teste do Limiar de Recepção da Fala
Falha de Tratamento
Resultado do Tratamento
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE; OBSERVATIONAL STUDY
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Diuretics); 0 (Gentamicins)
[Em] Mês de entrada:1410
[Cu] Atualização por classe:140822
[Lr] Data última revisão:
140822
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:140725
[St] Status:MEDLINE
[do] DOI:10.1001/jamaoto.2014.1249


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[PMID]:23048004
[Au] Autor:Vorobeichik L; Fallucco MA; Hagan RR
[Ad] Endereço:Saint Louis University School of Medicine, Saint Louis, MO, USA.
[Ti] Título:Chronic daily headaches secondary to greater auricular and lesser occipital neuromas following endolymphatic shunt surgery.
[So] Source:BMJ Case Rep;2012, 2012 Oct 09.
[Is] ISSN:1757-790X
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:In head and neck surgery, peripheral sensory nerves are at risk for traumatic injury. These injuries are known to be peripheral triggers of chronic headaches if left untreated or unrecognised. We report the case of a patient that presented with a severe headache, nausea and emesis of 2 years duration following endolymphatic shunt placement for Meniere's disease. Nerve blockade suggested a peripheral trigger, and surgical exploration of the incision site revealed traumatic neuromas of the greater auricular and lesser occipital nerves. Subsequent nerve resection yielded complete symptomatic relief. This is the first case report of a peripherally triggered migraine headache due to the development of neuromas of the greater auricular and lesser occipital nerves, also representing a previously unreported complication of endolymphatic shunt placement. It is recommended that in patients presenting with intractable migraines and a history of head and neck surgery, diagnostic nerve blockage be used to assess for neuromas.
[Mh] Termos MeSH primário: Nervos Cranianos/patologia
Anastomose Endolinfática/efeitos adversos
Transtornos da Cefaleia/etiologia
Doença de Meniere/cirurgia
Transtornos de Enxaqueca/etiologia
Neuroma/complicações
Complicações Pós-Operatórias/etiologia
[Mh] Termos MeSH secundário: Nervos Cranianos/cirurgia
Feminino
Transtornos da Cefaleia/cirurgia
Seres Humanos
Doença de Meniere/complicações
Meia-Idade
Transtornos de Enxaqueca/cirurgia
Náusea/etiologia
Bloqueio Nervoso
Neuroma/cirurgia
Procedimentos Neurocirúrgicos
Complicações Pós-Operatórias/cirurgia
Vômito/etiologia
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1302
[Cu] Atualização por classe:160519
[Lr] Data última revisão:
160519
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:121011
[St] Status:MEDLINE


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[PMID]:20713247
[Au] Autor:Teufert KB; Doherty J
[Ad] Endereço:House Ear Institute, Los Angeles, CA, USA. KTeufert@hei.org
[Ti] Título:Endolymphatic sac shunt, labyrinthectomy, and vestibular nerve section in Meniere's disease.
[So] Source:Otolaryngol Clin North Am;43(5):1091-111, 2010 Oct.
[Is] ISSN:1557-8259
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:Medical treatment for Meniere's disease is effective in controlling vertigo for approximately 85% of patients. However, when disabling vertigo continues, surgical therapy is indicated. Several surgical approaches are performed to control the symptoms of peripheral vestibular disorders refractory to medical measures, each procedure having many technical variations. Surgery is usually reserved for patients with disabling vertigo. Here, the authors discuss surgical options for vertigo control in Meniere's disease and review the literature on outcomes of these management options. The authors discuss endolymphatic sac shunt (ie, endolymphatic mastoid shunt), vestibular nerve section, cochleosacculotomy, and labyrinthectomy. When looking at data based on patient ratings, the authors find that surgery improves vertigo in endolymphatic sac shunt, vestibular nerve section, and labyrinthectomy groups and improves imbalance for the endolymphatic sac shunt and vestibular nerve section groups. Labyrinthectomy and translabyrinthine vestibular nerve section both offer excellent control of intractable vertigo. However, patients undergoing translab yrinthine vestibular nerve section are more likely to show improvement in imbalance and functional disability. This outcome is more likely for diagnoses other than Meniere's disease. There are potential prognostic factors that can be helpful in the preoperative or postoperative counseling of patients undergoing surgical treatment of vertigo. Patients who rate themselves as more disabled before surgery are less likely to achieve the best outcomes. Several other factors, such as duration of disease, contralateral tinnitus, eye disease, and allergy, may play a role.
[Mh] Termos MeSH primário: Doença de Meniere/cirurgia
[Mh] Termos MeSH secundário: Cóclea/cirurgia
Anastomose Endolinfática
Seres Humanos
Procedimentos Neurocirúrgicos
Nervo Vestibular/cirurgia
Vestíbulo do Labirinto/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1012
[Cu] Atualização por classe:100817
[Lr] Data última revisão:
100817
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:100818
[St] Status:MEDLINE
[do] DOI:10.1016/j.otc.2010.05.014


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[PMID]:20431498
[Au] Autor:Derebery MJ; Fisher LM; Berliner K; Chung J; Green K
[Ad] Endereço:House Ear Institute, University of Southern California, Los Angeles, California 90057, USA. jderebery@hei.org
[Ti] Título:Outcomes of endolymphatic shunt surgery for Ménière's disease: comparison with intratympanic gentamicin on vertigo control and hearing loss.
[So] Source:Otol Neurotol;31(4):649-55, 2010 Jun.
[Is] ISSN:1537-4505
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare proportions of the combined outcome of vertigo control and hearing preservation between intratympanic gentamicin injections and endolymphatic sac shunt surgery for intractable vertigo in Ménière's disease patients. STUDY DESIGN: Analysis of published data and retrospective review. SETTING: Tertiary otologic referral center. PATIENTS: Patients with Ménière's disease who had failed medical management: 183 surgical patients (shunt group) and 203 patients obtained from 6 published gentamicin treatment studies (gentamicin group). Cases were included if hearing and vertigo data were available before and after treatment with no previous surgical or injection treatment. Average patient age ranged from 45 to 59 years across studies. Gentamicin studies had nearly equal female to male subjects, whereas the shunt group was 60% female. INTERVENTIONS: Endolymphatic sac shunt surgery or intratympanic gentamicin treatment of differing doses and injection schedules. MAIN OUTCOME MEASURE: Proportion of patients with best combined vertigo control/hearing preservation. Hearing preservation is 10 dB or less increase in pure-tone average. Outcomes were categorized as follows: complete vertigo control/hearing preservation (best), complete vertigo control/hearing loss, incomplete vertigo control/hearing preservation, and incomplete vertigo control/hearing loss (worst). RESULTS: The shunt group showed a significantly higher percentage of the best outcome (62%) than the gentamicin group (56%, p
[Mh] Termos MeSH primário: Orelha Interna/cirurgia
Anastomose Endolinfática
Gentamicinas/uso terapêutico
Doença de Meniere/tratamento farmacológico
Doença de Meniere/cirurgia
[Mh] Termos MeSH secundário: Adulto
Idoso
Antibacterianos/administração & dosagem
Antibacterianos/uso terapêutico
Audiometria de Tons Puros
Distribuição de Qui-Quadrado
Feminino
Gentamicinas/administração & dosagem
Perda Auditiva/tratamento farmacológico
Perda Auditiva/cirurgia
Seres Humanos
Injeções
Masculino
Meia-Idade
Estudos Retrospectivos
Resultado do Tratamento
Vertigem/tratamento farmacológico
Vertigem/cirurgia
Testes de Função Vestibular
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Gentamicins)
[Em] Mês de entrada:1010
[Cu] Atualização por classe:100526
[Lr] Data última revisão:
100526
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:100501
[St] Status:MEDLINE
[do] DOI:10.1097/MAO.0b013e3181dd13ac


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[PMID]:19506891
[Au] Autor:Park JJ; Chen YS; Westhofen M
[Ad] Endereço:Department of Otorhinolaryngology and Head and Neck Surgery, RWTH University Aachen, Pauwelsstrasse 30, 52074 Aachen, Germany. jpark@ukaachen.de
[Ti] Título:Impact of endolymphatic mastoid shunt surgery on saccule and lateral semicircular canal function.
[So] Source:Eur Arch Otorhinolaryngol;267(1):21-6, 2010 Jan.
[Is] ISSN:1434-4726
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Endolymphatic mastoid shunt surgery (EMSS) is widely performed in patients with medically intractable Meniere's disease. Although many patients report an improvement of symptoms after surgery, the mechanisms which are responsible for the relief of complaints are not known. To date, only few studies exist which studied the influence of EMSS on vestibular function. The present study examines the effect of EMSS on saccule function by measuring vestibular evoked myogenic potentials and the effect on lateral semicircular canal function by sinusoidal harmonic acceleration (SHA) testing. No changes in vestibulo-collic reflexes were found after surgery compared to before surgery. SHA testing resulted in comparable phase lag and gain pre- and postoperatively. Although central compensation is clinically evident no effect in specific vestibular diagnostic testing is seen. Modulations of canal-otolith interaction might suggest a change of symptoms. The only method so far to evaluate the success of EMSS is the patient's subjective assessment.
[Mh] Termos MeSH primário: Anastomose Endolinfática/métodos
Processo Mastoide/cirurgia
Doença de Meniere/cirurgia
Membrana dos Otólitos/cirurgia
Sáculo e Utrículo/fisiopatologia
Canais Semicirculares/fisiopatologia
Potenciais Evocados Miogênicos Vestibulares/fisiologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Seres Humanos
Masculino
Doença de Meniere/fisiopatologia
Meia-Idade
Membrana dos Otólitos/fisiopatologia
Estudos Retrospectivos
Sáculo e Utrículo/cirurgia
Canais Semicirculares/cirurgia
Resultado do Tratamento
Testes de Função Vestibular
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Em] Mês de entrada:1107
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:090610
[St] Status:MEDLINE
[do] DOI:10.1007/s00405-009-0998-4


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[PMID]:20112519
[Au] Autor:Salvinelli F; Miele A; Rinaldi V; Pappacena M; Trivelli M
[Ad] Endereço:Area of Otolaryngology, Campus Bio-Medico University, Rome, Italy.
[Ti] Título:Study of vestibular evoked myogenic potentials in patients affected by Meniere's disease treated with endolymphatic mastoid shunt.
[So] Source:Ann Otol Rhinol Laryngol;118(12):852-8, 2009 Dec.
[Is] ISSN:0003-4894
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: We recorded and compared the vestibular evoked myogenic potentials (VEMPs) before use of an endolymphatic mastoid shunt (EMS) and 1, 12, and 48 months after placement of the shunt. METHODS: Air-conducted VEMPs were recorded in 28 patients affected by intractable Meniere's disease and treated with placement of an EMS. RESULTS: One month and 12 months after the surgery, VEMPs were not detectable in the operated ear in 100% and 86% of the patients, respectively. Forty-eight months after the surgery, they were elicited in 79% of the patients. CONCLUSIONS: We conclude that VEMPs are a clinically useful tool in the postoperative follow-up of patients with an EMS.
[Mh] Termos MeSH primário: Anastomose Endolinfática
Potenciais Evocados Auditivos/fisiologia
Potencial Evocado Motor/fisiologia
Doença de Meniere/fisiopatologia
Doença de Meniere/cirurgia
Vestíbulo do Labirinto/fisiopatologia
[Mh] Termos MeSH secundário: Adulto
Idoso
Feminino
Seguimentos
Seres Humanos
Masculino
Processo Mastoide
Meia-Idade
Reflexo Acústico/fisiologia
Estudos Retrospectivos
Resultado do Tratamento
Testes de Função Vestibular
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1002
[Cu] Atualização por classe:170214
[Lr] Data última revisão:
170214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:100202
[St] Status:MEDLINE


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[PMID]:19643258
[Au] Autor:Yu MS; Lee KS; Chung JW
[Ad] Endereço:Department of Otolaryngology, Asan Medical Center, University of Ulsan, College of Medicine, Seoul, Korea.
[Ti] Título:Long-term results of endolymphatic mastoid shunt surgery in patients with intractable Ménière's disease.
[So] Source:Otolaryngol Head Neck Surg;141(2):237-42, 2009 Aug.
[Is] ISSN:0194-5998
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To evaluate changes in vertigo and hearing from patients with Ménière's disease managed by endolymphatic mastoid shunt (EMS). STUDY DESIGN: Case series with chart review. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Data from 16 patients were analyzed using 1995 AAO-HNS criteria. RESULTS: Among 16 patients, six had class A vertigo control two years after treatment, five had class B, one class C, three class D, and one class F. At four years after surgery, seven patients had class A, four class B, three class C, and two class F. The mean functional level before surgery was 4.8 and improved to 2.9 and 2.6 at two years and four years after surgery, respectively. The bone conduction pure-tone averages (four frequencies) were 43.3 before surgery and improved to 33.5 dB HL and 35.5 dB HL at three and six months after surgery, respectively. At two years of follow-up, the hearing level was 38.6 dB HL and was not different from the preoperative hearing level. Two years after surgery, the hearing level gradually decreased and was 42.0 dB HL at five years of follow-up. CONCLUSION: EMS appears to be beneficial in the short term for the symptomatic patients.
[Mh] Termos MeSH primário: Audiometria de Tons Puros/métodos
Anastomose Endolinfática/métodos
Audição
Processo Mastoide/cirurgia
Doença de Meniere/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Feminino
Seguimentos
Hospitais Universitários
Seres Humanos
Masculino
Processo Mastoide/fisiopatologia
Doença de Meniere/fisiopatologia
Meia-Idade
Qualidade de Vida
Estudos Retrospectivos
Percepção da Fala
Fatores de Tempo
Resultado do Tratamento
Vertigem/cirurgia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:0909
[Cu] Atualização por classe:090731
[Lr] Data última revisão:
090731
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:090801
[St] Status:MEDLINE
[do] DOI:10.1016/j.otohns.2009.03.014


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[PMID]:19140530
[Au] Autor:Lee L; Pensak ML
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati Academic Health Center, 231 Albert Sabin Way, OH 45267-0528, USA.
[Ti] Título:Contemporary role of endolymphatic mastoid shunt surgery in the era of transtympanic perfusion strategies.
[So] Source:Ann Otol Rhinol Laryngol;117(12):871-5, 2008 Dec.
[Is] ISSN:0003-4894
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES: Although there exist undisputed methods to permanently silence the aberrant end organ, controversy surrounds the durable efficacy of non-ablative interventions. This study provides a contemporary review of our institution's clinical experience in performing endolymphatic mastoid shunt surgery (EMSS) in patients with medically refractory endolymphatic hydrops, or Meniere's disease. METHODS: Between 1984 and 2002, 1,612 patients were referred to our institution with a diagnosis of Meniere's disease. Of these referrals, 1,172 patients met the criteria for Meniere's disease. Although 553 patients responded to medical management, 486 patients underwent EMSS and 133 patients had refractory disease that required chemical or surgical obliterative interventions. The retrospective study utilizes data collected on 226 patients who were followed for a minimum of 5 years. RESULTS: Overall, 78% patients responded favorably to EMSS, according to the functional level scale and class categories delineated by the American Academy of Otolaryngology-Head and Neck Surgery 1995 guidelines for control of vertigo. According to the Arenberg anatomic classification for endolymphatic sac location, EMSS achieved adequate control of vertigo in 86% of type I cases, 90% of type II cases, and 82% of type III cases. CONCLUSIONS: Endolymphatic mastoid shunt surgery is a relatively safe, effective procedure for the long-term control of vertigo in patients with medically refractory Meniere's disease.
[Mh] Termos MeSH primário: Anastomose Endolinfática
Doença de Meniere/cirurgia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Idoso
Antibacterianos/uso terapêutico
Orelha Interna/cirurgia
Feminino
Seguimentos
Gentamicinas/uso terapêutico
Seres Humanos
Masculino
Doença de Meniere/classificação
Meia-Idade
Estudos Retrospectivos
Índice de Gravidade de Doença
Membrana Timpânica
Vertigem/terapia
Nervo Vestibular/cirurgia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Gentamicins)
[Em] Mês de entrada:0902
[Cu] Atualização por classe:170214
[Lr] Data última revisão:
170214
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:090115
[St] Status:MEDLINE



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