RESUMEN
Summary--A surgical approach to the internal auditory canal is presented which as proved useful in the following circumstances: 1) as a destructive procedure in Ménière's disease, 2) as a diagnostic procedure in patients in whom an acoustic neurinoma is suspected and a labrinthectomy is indicated. In this situation the tumor may be removed during the same operative procedure, 3) for the removal of small, mobile, intracanalicular neurionomas, and 4) for complete facial nerve decompression in patients with no vestibular response and no serviceable hearing.
Asunto(s)
Neoplasias del Oído/cirugía , Oído Interno/cirugía , Parálisis Facial/cirugía , Enfermedad de Meniere/cirugía , Neurilemoma/cirugía , Hueso Petroso/cirugía , Nervio Coclear/cirugía , Neoplasias del Oído/diagnóstico , Osículos del Oído/cirugía , Oído Interno/inervación , Humanos , Enfermedad de Meniere/diagnóstico , Métodos , Neurilemoma/diagnóstico , Nervio Vestibular/cirugía , Vestíbulo del LaberintoRESUMEN
Surgery of the endolymphatic sac is controversial. Some consider it a placebo and others consider it the surgical treatment of choice in Ménière's disease. We studied the medical records of 87 patients who underwent surgery between 1978 and 1996. Simple decompression was practiced in 89% and a House shunt in 27.6%. The 1-year results were improvement or recovery from vertigo in 65.4%, no improvement in 25%, and reoperation in 9.5%. Tinnitus improved in only 11.9% and hearing loss improved in 9.5% and worsened in 19%. We reviewed the cases of 50 patients with a 5-year follow-up(60%). Vertigo improved in 72%,hearing loss worsened in 72%, and tinnitus remained unchanged in 78%. In view of the good results, scant complications and simplicity of the surgical procedure, we consider endolymphatic saccule surgery to be the first choice in Ménière's disease that is unresponsive to medical treatment.
Asunto(s)
Saco Endolinfático/cirugía , Enfermedades del Laberinto/cirugía , Femenino , Humanos , MasculinoRESUMEN
We review the surgical findings of 85 revisional radical mastoidectomies for recurrent otic discharge, with the purpose to determinate the causes of surgical failure. Cholesteatoma was found in 38.8% of the cases. The other causes were unexentered cells and granulation tissue in the sinodural angle, mastoid tip, tegmental cells and root of the zygoma. The facial recess was the place of residual cholesteatoma in 47% and the supratubal recces in 40% of the cases. We emphasized the big importance of a good meatoplasty, this was the cause of failure in 62.4% of cases. A dry ear was obtained in 94% of the cases. The mean following up period was three years.