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Inicio Acta Otorrinolaringológica Española Bifenestral surgical and chemical labyrinthectomy, a new effective ablative surg...
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Vol. 74. Issue 3.
Pages 169-174 (May - June 2023)
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Vol. 74. Issue 3.
Pages 169-174 (May - June 2023)
Original article
Bifenestral surgical and chemical labyrinthectomy, a new effective ablative surgical approach to intractable vertigo in Ménière disease elderly patients
Laberintectomía química y quirúrgica bifenestral, una nueva técnica ablativa eficaz para el vértigo intratable en pacientes ancianos con enfermedad de Ménière
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Fabrizio Salvinellia, Francesca Bonifaciob,
Corresponding author
, Maurizio Trivellib, Fabio Grecob, Valeria Frarib, Domenico Amadiob
a Research Unit of Otorhinolaryngology, Campus Biomedico Universty, Rome
b Department of Otorhinolaryngology, Fondazione Policlinico Campus Biomedico, Via Alvaro del Portillo n. 200 - 00128 Roma
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Abstract
Introduction

In this article, the bi-fenestral surgical chemical labyrinthectomy is introduced as a surgical demolition technique for treating resisting incurable forms of Meniere’s disease in patients aged over 70 and/or with low hearing residues refractory to medical treatment.

Materials and methods

The results on participants fitting the inclusion criteria (n = 16) were reported using anamnesis (frequency of the crisis), Dizziness Handicap Inventory (DHI) and Functional Level Scale (FLS) before and after the intervention.

Results

Vertigo control was achieved in all patients of this case series. A difference of 57 and 3.67 in mean DHI (from 68 (SD 16.7) to 11 (SD 14)) and FLS (from 4.68 (SD 0.7) to 0.1 (SD 0.3)) scores respectively were seen after an average of 16.28 months. Contextually tinnitus was reported to improve in seven patients (43.75%), aggravate in three (18.75%) and remain unchanged in the remaining six (37.5%).

Conclusion

Bi-fenestral surgical chemical labyrinthectomy appears a safe, immediate, and effective demolition treatment for vertigo control in a restricted class of patients affected by intractable Meniere disease.

Keywords:
Vertigo
Dizziness
Meniere disease
Tinnitus
Hearing loss
Resumen
Introducción

En este artículo se presenta la laberintectomía química quirúrgica bifenestral como técnica quirúrgica de demolición para el tratamiento de formas resistentes e incurables de la enfermedad de Meniere en pacientes mayores de 70 años y/o con baja audición refractaria al tratamiento médico.

Materiales y métodos

Los resultados de los participantes que cumplieron con los criterios de inclusión (n = 16) se informaron mediante anamnesis (frecuencia de las crisis), Dizziness Handicap Inventory (DHI) y Functional Level Scale (FLS) antes y después de la intervención.

Resultados

Se logró el control del vértigo en todos los pacientes de esta serie de casos. Una diferencia de 57 y 3,67 en las puntuaciones medias de DHI (de 68 (DE 16,7) a 11 (DE 14)) y FLS (de 4,68 (DE 0,7) a 0,1 (DE 0,3)) respectivamente fueron vistos después de un promedio de 16,28 meses. Contextualmente, se informó que el tinnitus mejoró en siete pacientes (43,75%), se agravó en tres (18,75 %) y permaneció sin cambios en los seis restantes (37,5%).

Conclusión

La laberintectomía química quirúrgica bifenestral parece un tratamiento de demolición seguro, inmediato y efectivo para el control del vértigo en una clase restringida de pacientes afectados por la enfermedad de Meniere intratable.

Palabras-clave:
Vértigo
Mareos
Enfermedad de Meniere
Tinnitus
Pérdida de audición

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