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1.
Medicine (Baltimore) ; 98(35): e16998, 2019 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-31464952

RESUMO

RATIONALE: Syncope caused by head and neck cancer (HNC) is rare. However, syncope caused by tongue cancer (TC) is even rarer. In TC, syncope is caused by tumor-mediated compression of the carotid sinus and stimulation of the glossopharyngeal nerve. PATIENT CONCERNS: In this study, we report the case of a 48-year-old male patient who was diagnosed with advanced TC and bilateral cervical lymph node metastasis. On the third day of admission, the patient experienced recurrent syncope with hypotension and bradycardia. DIAGNOSES: The patient was diagnosed with a well-differentiated squamous cell carcinoma of the tongue along with massive cervical lymph node metastasis and carotid sinus syndrome. INTERVENTIONS: Initially, symptomatic treatment of syncope boosted the blood pressure and increased the heart rate. Thereafter, a temporary pacemaker was implanted. Finally, chemotherapy was used to control the tumor and relieve syncope. OUTCOMES: After chemotherapy, the tongue ulcers and cervical lymph node reduced in size; syncope did not recur. LESSONS: This case shows that chemotherapy may be a valid treatment option in patients with cancer-related syncope; however, the choice of chemotherapeutic drugs is critical. Intensive care provides life support to patients and creates opportunities for further treatment.


Assuntos
Cuidados Paliativos , Síncope/complicações , Neoplasias da Língua/complicações , Antineoplásicos/uso terapêutico , Pressão Sanguínea , Seio Carotídeo/patologia , Nervo Glossofaríngeo/patologia , Frequência Cardíaca , Humanos , Metástase Linfática , Masculino , Pessoa de Meia-Idade , Marca-Passo Artificial , Síncope/cirurgia , Neoplasias da Língua/tratamento farmacológico , Neoplasias da Língua/patologia
2.
Intern Med ; 58(14): 2041-2044, 2019 Jul 15.
Artigo em Inglês | MEDLINE | ID: mdl-30918200

RESUMO

An 84-year-old man presented with syncope. Prior to admission, ambulatory electrocardiogram had demonstrated non-sustained ventricular tachycardia. Echocardiography showed severe aortic stenosis. He was also diagnosed with hypertrophic cardiomyopathy (HCM) by cardiac magnetic resonance (CMR) showing remarkable inhomogeneous left ventricular hypertrophy and extensive late gadolinium enhancement (LGE) in the lesions at the upper border and right-ventricular side of the basal-mid septal wall. Finally, he showed complete atrioventricular (AV) block followed by a long pause and syncope several times after admission. In this case with several possible causes of syncope, the CMR findings suggested a clue concerning the etiology of his syncope: complete AV block in HCM.


Assuntos
Bloqueio Atrioventricular/complicações , Cardiomiopatia Hipertrófica/diagnóstico por imagem , Fibrose/diagnóstico por imagem , Hipertrofia Ventricular Esquerda/complicações , Imagem Cinética por Ressonância Magnética/métodos , Marca-Passo Artificial , Síncope/complicações , Idoso de 80 Anos ou mais , Estenose da Valva Aórtica , Bloqueio Atrioventricular/cirurgia , Meios de Contraste , Eletrocardiografia Ambulatorial/métodos , Fibrose/cirurgia , Gadolínio DTPA , Ventrículos do Coração/fisiopatologia , Humanos , Hipertrofia Ventricular Esquerda/cirurgia , Masculino , Miocárdio/patologia , Síncope/cirurgia , Resultado do Tratamento
3.
J Neurosurg Pediatr ; 23(3): 303-307, 2018 12 21.
Artigo em Inglês | MEDLINE | ID: mdl-30579267

RESUMO

Corpus callosotomy has been used as a form of surgical palliation for patients suffering from medically refractory generalized seizures, including drop attacks. Callosotomy has traditionally been described as involving a craniotomy with microdissection. MR-guided laser interstitial thermal therapy (MRg-LITT) has recently been used as a minimally invasive method for performing surgical ablation of epileptogenic foci and corpus callosotomy. The authors present 3 cases in which MRg-LITT was used to perform a corpus callosotomy as part of a staged surgical procedure for a patient with multiple seizure types and in instances when further ablation of residual corpus callosum is necessary after a prior open surgical procedure. To the authors' knowledge, this is the first case series of corpus callosotomy performed using the MRg-LITT system with a 3.3-year average follow-up. Although MRg-LITT is not expected to replace the traditional corpus callosotomy in all cases, it is a safe, effective, and durable alternative to the traditional open corpus callosotomy, particularly in the setting of a prior craniotomy.


Assuntos
Corpo Caloso/cirurgia , Epilepsia Resistente a Medicamentos/cirurgia , Epilepsia Generalizada/cirurgia , Terapia a Laser/métodos , Imagem por Ressonância Magnética Intervencionista/métodos , Síncope/cirurgia , Adolescente , Corpo Caloso/diagnóstico por imagem , Epilepsia Resistente a Medicamentos/complicações , Epilepsia Resistente a Medicamentos/tratamento farmacológico , Epilepsia Generalizada/complicações , Epilepsia Generalizada/tratamento farmacológico , Feminino , Hemisferectomia , Humanos , Lactente , Imagem por Ressonância Magnética , Masculino , Procedimentos Cirúrgicos Robóticos/métodos , Síncope/etiologia , Resultado do Tratamento , Adulto Jovem
5.
World Neurosurg ; 114: 161-164, 2018 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-29551725

RESUMO

OBJECTIVE: To our knowledge, there have not been any reported cases of a meningioma of the craniocervical region presenting solely with syncope as its initial symptom. Only 1 case of meningioma presenting with syncope has been published, but it was associated with hydrocephalus. We report 2 cases of syncope caused by a craniocervical junction meningioma, with syncope being the sole presenting symptom and without hydrocephalus. We discuss the possible pathophysiology, as well as the clinical relevance of this type of presentation. METHODS: We reviewed the charts, operative details, and imagery of 2 cases of meningioma in the region of the craniocervical junction, with syncope as their sole presenting feature. We also reviewed the literature. RESULTS: In 1 case the syncope occurred spontaneously. In the other, it occurred during a Valsalva maneuver. Both meningiomas were surgically removed via a retromastoid approach. There was no recurrence of syncope following surgery. Following a literature review, we found 1 case of posterior fossa meningioma presenting with syncope, but hydrocephalus was also present. CONCLUSION: Syncope can be the sole manifestation of a meningioma of the craniocervical junction. Such syncopes are a consequence of transient dysfunction of the autonomous pathways in the medulla and/or of the medulla's output. In the absence of other causes of syncope, a meningioma in this region, even in the absence of hydrocephalus, should not be considered as fortuitous, but rather as the actual cause of syncope. Recognizing this possibility offers the potential for proper diagnosis and appropriate treatment of the syncope.


Assuntos
Vértebras Cervicais/diagnóstico por imagem , Forame Magno/efeitos dos fármacos , Hidrocefalia , Neoplasias Meníngeas/diagnóstico por imagem , Meningioma/diagnóstico por imagem , Síncope/diagnóstico por imagem , Vértebras Cervicais/cirurgia , Feminino , Forame Magno/cirurgia , Humanos , Neoplasias Meníngeas/complicações , Neoplasias Meníngeas/cirurgia , Meningioma/complicações , Meningioma/cirurgia , Pessoa de Meia-Idade , Síncope/complicações , Síncope/cirurgia
8.
Heart Vessels ; 32(3): 341-351, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27480879

RESUMO

The prognostic value of the seasonal variations of T-wave alternans (TWA) and heart rate variability (HRV), and the seasonal distribution of ventricular fibrillation (VF) in Brugada syndrome (Br-S) is unknown. We assessed the utility of seasonal variations in TWA and HRV for risk stratification in Br-S using a 24-h multichannel Holter electrocardiogram (24-M-ECG). We enrolled 81 patients with Br-S (grouped according to their history of VF, n = 12; syncope, n = 8; no symptoms, n = 61) who underwent 24-M-ECG in all four seasons. Precordial electrodes were attached to the third (3L-V2) and fourth (4L-V2, 4L-V5) intercostal spaces. We determined the maximum TWA (max-TWA) values and calculated HRV during night and morning time periods for all seasons. During a follow-up period of 5.8 ± 2.8 years, 11 patients experienced new VF episodes and there was a peak in new VF episodes in the summer. The VF group had the greatest 3L-V2 max-TWA value during morning time in the summer among the three groups and showed higher 3L-V2 max-TWA value than in the other seasons. The cutoff value for the 3L-V2 max-TWA during morning time in the summer was determined to be 42 µV using ROC analysis (82 % sensitivity, 74 % specificity; p = 0.0006). Multivariate analysis revealed that a 3L-V2 max-TWA value ≥42 µV during morning time in the summer and previous VF episodes were predictors of future VF episodes. The 3L-V2 max-TWA value during morning time in the summer may be a useful predictor of future VF episodes in Br-S.


Assuntos
Síndrome de Brugada/complicações , Desfibriladores Implantáveis , Estações do Ano , Síncope/cirurgia , Fibrilação Ventricular/diagnóstico , Fibrilação Ventricular/cirurgia , Adulto , Idoso , Eletrocardiografia Ambulatorial , Feminino , Frequência Cardíaca , Humanos , Japão , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Análise Multivariada , Curva ROC , Medição de Risco , Sensibilidade e Especificidade , Síncope/etiologia
9.
Heart Lung Circ ; 26(4): e22-e25, 2017 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-27743856

RESUMO

Intracardiac leiomyomatosis is a rare complication that occurs when a uterine leiomyoma (fibroid) undergoes vascular invasion and propagates within the inferior vena cava to reach the right atrium. This article describes a case of intracardiac leiomyomatosis in a middle-aged woman, exploring the presentation, diagnosis and surgical management of this condition. In this case the presenting complaints were syncope and atrial fibrillation, illustrating the importance of performing a transthoracic echocardiogram in patients presenting with their first episode of atrial fibrillation. Clinicians should consider intracardiac leiomyomatosis when evaluating women with right heart masses, especially those with a history of uterine leiomyomas.


Assuntos
Fibrilação Atrial , Ecocardiografia , Neoplasias Cardíacas , Leiomiomatose , Síncope , Neoplasias Uterinas , Fibrilação Atrial/etiologia , Fibrilação Atrial/fisiopatologia , Fibrilação Atrial/cirurgia , Feminino , Neoplasias Cardíacas/fisiopatologia , Neoplasias Cardíacas/secundário , Neoplasias Cardíacas/cirurgia , Humanos , Leiomiomatose/fisiopatologia , Leiomiomatose/cirurgia , Pessoa de Meia-Idade , Síncope/etiologia , Síncope/fisiopatologia , Síncope/cirurgia , Neoplasias Uterinas/fisiopatologia , Neoplasias Uterinas/cirurgia
10.
Neurology ; 87(19): 1968-1974, 2016 Nov 08.
Artigo em Inglês | MEDLINE | ID: mdl-27733569

RESUMO

OBJECTIVE: To evaluate a novel approach to control epileptic drop attacks through a selective posterior callosotomy, sparing all prefrontal interconnectivity. METHODS: Thirty-six patients with refractory drop attacks had selective posterior callosotomy and prospective follow-up for >4 years. Falls, episodes of aggressive behavior, and IQ were quantified. Autonomy in activities of daily living, axial tonus, and speech generated a functional score ranging from 0 to 13. Subjective effect on patient well-being and caregiver burden was also assessed. RESULTS: Median monthly frequency of drop attacks decreased from 150 to 0.5. Thirty patients (83%) achieved either complete or >90% control of the falls. Need for constant supervision decreased from 90% to 36% of patients. All had estimated IQ below 85. Median functional score increased from 7 to 10 (p = 0.03). No patient had decrease in speech fluency or hemiparesis. Caregivers rated the effect of the procedure as excellent in 40% and as having greatly improved functioning in another 50%. Clinical, EEG, imaging, and cognitive variables did not correlate with outcome. CONCLUSIONS: This cohort study with objective outcome assessment suggests that selective posterior callosotomy is safe and effective to control drop attacks, with functional and behavioral gains in patients with intellectual disability. Results are comparable to historical series of total callosotomy and suggest that anterior callosal fibers may be spared. CLASSIFICATION OF EVIDENCE: This study provides Class III evidence that selective posterior callosotomy reduces falls in patients with epileptic drop attacks.


Assuntos
Corpo Caloso/cirurgia , Córtex Pré-Frontal/fisiologia , Psicocirurgia/métodos , Síncope/cirurgia , Atividades Cotidianas , Adolescente , Adulto , Criança , Eletroencefalografia , Epilepsia/complicações , Epilepsia/cirurgia , Feminino , Humanos , Estudos Longitudinais , Masculino , Análise Multivariada , Vias Neurais/cirurgia , Estudos Retrospectivos , Síncope/etiologia , Resultado do Tratamento , Gravação em Vídeo , Adulto Jovem
11.
Tex Heart Inst J ; 43(3): 236-40, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27303240

RESUMO

We discuss the case of a 38-year-old black man who presented at our hospital with his first episode of syncope, recently developed atrial arrhythmias refractory to pharmacologic therapy, and a left atrial thrombus. He was diagnosed with primary cardiac sarcoidosis characterized by predominant involvement of the epicardium that caused atrial fibrillation and atrial flutter. Histologic analysis of his epicardial lesions yielded a diagnosis of sarcoidosis. This patient's atrial arrhythmia was successfully treated with a hybrid operation that involved resection of his atrial appendage, an Epicor maze procedure, and radiofrequency ablation during a catheter-based electrophysiologic study. The cardiac sarcoidosis was successfully managed with corticosteroid therapy. Our case report shows that sarcoidosis can initially manifest itself as syncope with new-onset atrial arrhythmia. Sarcoidosis is important in the differential diagnosis because of its progressive nature and its potential for treatment with pharmacologic, surgical, and catheter-based interventions.


Assuntos
Apêndice Atrial/cirurgia , Fibrilação Atrial/etiologia , Cardiomiopatias/complicações , Ablação por Cateter/métodos , Sistema de Condução Cardíaco/fisiopatologia , Sarcoidose/complicações , Síncope/etiologia , Adulto , Apêndice Atrial/diagnóstico por imagem , Fibrilação Atrial/diagnóstico , Fibrilação Atrial/cirurgia , Procedimentos Cirúrgicos Cardíacos/métodos , Cardiomiopatias/diagnóstico , Cardiomiopatias/cirurgia , Ecocardiografia , Eletrocardiografia , Sistema de Condução Cardíaco/cirurgia , Humanos , Imagem Tridimensional , Masculino , Sarcoidose/diagnóstico , Sarcoidose/cirurgia , Síncope/diagnóstico , Síncope/cirurgia
12.
J Vet Cardiol ; 18(2): 187-93, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-26923757

RESUMO

Two young Labrador retriever dogs with bradycardia-induced syncope resulting from atrial myopathy underwent permanent transvenous pacemaker implantation. Both dogs developed heart failure 3-5 years after pacemaker implantation. Both were managed medically for approximately 7 years after pacemaker implantation and, ultimately, were humanely euthanized due to refractory heart failure signs and quality of life concerns. Long-term management of dogs with atrial myopathy and secondary atrial standstill with pacemaker implantation and medical therapy for heart failure is feasible and prognosis may be better than previously reported or speculated.


Assuntos
Cardiomiopatias/veterinária , Doenças do Cão/terapia , Doenças Genéticas Inatas/veterinária , Átrios do Coração/anormalidades , Bloqueio Cardíaco/veterinária , Insuficiência Cardíaca/veterinária , Marca-Passo Artificial/veterinária , Animais , Cardiomiopatias/terapia , Cães , Feminino , Doenças Genéticas Inatas/terapia , Bloqueio Cardíaco/terapia , Insuficiência Cardíaca/terapia , Masculino , Prognóstico , Síncope/cirurgia , Síncope/veterinária
13.
Eur Rev Med Pharmacol Sci ; 20(3): 498-501, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26914125

RESUMO

Some cases of Coffin-Lowry syndrome recognized episodic drops and it tended to be intractable for medical treatment. We reported here a patient with the Coffin-Lowry syndrome associated with obstructive sleep apnea syndrome (OSAS). The patient had epileptic seizures and drop attacks only during night-time and it was not recognized during the daytime. His sleep-induced electroencephalogram was normal. At 12-years old of his age, his OSAS was worse, so we performed a tracheotomy. Notably after the operation, his epileptic episodes were disappeared.


Assuntos
Síndrome de Coffin-Lowry/diagnóstico , Apneia Obstrutiva do Sono/diagnóstico , Síncope/diagnóstico , Traqueotomia , Criança , Síndrome de Coffin-Lowry/complicações , Síndrome de Coffin-Lowry/cirurgia , Eletroencefalografia , Humanos , Masculino , Apneia Obstrutiva do Sono/complicações , Apneia Obstrutiva do Sono/cirurgia , Síncope/complicações , Síncope/cirurgia
14.
Rev Med Liege ; 71(7-8): 360-363, 2016 Jul.
Artigo em Francês | MEDLINE | ID: mdl-28383846

RESUMO

Syncope accounts for nearly 5 % of the emergency intake causes. Swallow syncope is a rare form of cardio-neurogenic syncope. Less than a hundred cases were reported since its first description in the mid-18th century. We present the case of an 83-year-old patient with recurrent syncope occurring during meals. Telemetry monitoring revealed a severe bradycardia with complete AV block and a pause of 8 seconds. A dual chamber pacemaker was implanted and the syncopal episodes were abolished. We shall briefly review the diagnostic methods, mechanisms, and therapy of swallow syncope.


Assuntos
Deglutição/fisiologia , Síncope/diagnóstico , Idoso de 80 Anos ou mais , Estenose das Carótidas/complicações , Estenose das Carótidas/cirurgia , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/etiologia , Transtornos de Deglutição/cirurgia , Eletrocardiografia , Humanos , Masculino , Marca-Passo Artificial , Síncope/etiologia , Síncope/cirurgia
15.
Clin Neurophysiol ; 127(1): 221-229, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26187350

RESUMO

OBJECTIVE: Gradient magnetic field topography (GMFT) with magnetoencephalography (MEG) has been developed to demonstrate magnetic-field gradients of epileptic spikes on a volume-rendered brain surface. We evaluated GMFT in patients with anterior 2/3 corpus callosotomy (ACC) for drop-attacks. METHODS: Eight patients (age; 11-37 years) underwent ACC. GMFT evaluated the predominant distributions (anterior/posterior) and the spreading patterns (unilateral/bilateral) of pre- and postoperative interictal MEG spikes corresponding to generalized spikes on EEG. We compared the occurrence of four types of spikes; anterior unilateral spike (AUS), posterior unilateral spike (PUS), anterior bilateral spike (ABS), posterior bilateral spike (PBS) between 5 patients (group G) with good control of drop attacks and 3 patients (group P) with residual drop attacks. RESULTS: Preoperatively, GMFT showed the proportion of ABS in group G (mean ± SD, 57.4 ± 9.7%) was significantly (p=0.024) higher than that in group P (31.6 ± 15.2%). The number and proportion of postoperative ABS and PBS in group G were significantly decreased (p<0.05 in all). CONCLUSION: GMFT is valuable to evaluate pre- and post-operative predominant spikes in patients with drop attacks. SIGNIFICANCE: GMFT revealed a higher proportion of preoperative ABS and postoperative decline of both ABS and PBS in patients with good control of drop attacks after ACC.


Assuntos
Corpo Caloso/fisiopatologia , Corpo Caloso/cirurgia , Campos Magnéticos , Magnetoencefalografia/métodos , Síncope/diagnóstico , Síncope/cirurgia , Adolescente , Adulto , Criança , Feminino , Humanos , Masculino , Valor Preditivo dos Testes , Cuidados Pré-Operatórios/métodos , Síncope/fisiopatologia , Adulto Jovem
17.
Pacing Clin Electrophysiol ; 39(1): 42-53, 2016 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-26411271

RESUMO

BACKGROUND: Cardio neuroablation (CNA) is a lesser-known technique for management of patients with excessive vagal activation on the basis of radiofrequency catheter ablation (RFCA) of the areas related to the three main autonomic ganglia around the heart. We investigated the effectiveness of selective and/or stepwise RFCA of these areas via right atrium (RA) and/or left atrium (LA) in the patients with recurrent syncope due to excessive vagal activity. METHODS: Twenty-two patients presenting symptomatic functional bradyarrhythmias, neurally mediated reflex syncope (NMS), symptomatic atrioventricular (AV) block, and symptomatic sinus node dysfunction (SND; number = 8, 7, 7, respectively) were enrolled. The three main paracardiac ganglia were targeted via RA and LA in the patients with NMS and SND. The procedure was performed via RA in the patients with AV block, followed by RFCA of all ganglia via LA, if AV conduction disorder persists. The sites showing fragmented potentials were identified by electrical mapping and verified by high-frequency stimulation and ablated until atrial electrical potential was completely eliminated (<0.1 mV). RESULTS: The patients with NMS and SND were free from new syncopal episode at a mean 12.3 ± 3.4 months and 9.5 ± 3.1 months follow-up, respectively. Ablation from RA was successful in six of seven patients with AV block. Despite the increased heart rate, the resolution of AV block after the RFCA could not be achieved in one patient who had partial resolution with atropine infusion on admission. CONCLUSION: CNA may be an alternative and safe strategy to reduce NMS episodes, and to treat functional AV block and symptomatic SND, especially in young patients.


Assuntos
Bloqueio Atrioventricular/cirurgia , Bradicardia/cirurgia , Ablação por Cateter/métodos , Síndrome do Nó Sinusal/cirurgia , Síncope/cirurgia , Nervo Vago/cirurgia , Adolescente , Adulto , Idoso , Bloqueio Atrioventricular/diagnóstico , Bradicardia/complicações , Bradicardia/diagnóstico , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Neurocirúrgicos/métodos , Síncope/diagnóstico , Resultado do Tratamento , Adulto Jovem
18.
J Neurosurg ; 123(5): 1322-5, 2015 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-26047417

RESUMO

A 2-stage corpus callosotomy is accepted as a palliative procedure for patients older than 16 years with, in particular, medically intractable generalized epilepsy and drop attack seizures and is preferable for a lower risk of disconnection syndrome. Although the methods by which a previously performed craniotomy can be reopened for posterior callosotomy have already been reported, posterior corpus callosotomy using a parietooccipital interhemispheric approach with the patient in a semi-prone park-bench position has not been described in the literature. Here, the authors present a surgical technique for posterior callosotomy using a parietooccipital interhemispheric approach with a semi-prone park-bench position as a second surgery. Although this procedure requires an additional skin incision in the parietooccipital region, it makes the 2-stage callosotomy safer and easier to perform because of reduced intracranial adhesion, less bleeding, and an easier approach to the splenium of the corpus callosum.


Assuntos
Corpo Caloso/cirurgia , Procedimentos Neurocirúrgicos/métodos , Lobo Occipital/cirurgia , Lobo Parietal/cirurgia , Posicionamento do Paciente/métodos , Decúbito Ventral , Adolescente , Adulto , Epilepsia Resistente a Medicamentos/cirurgia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Segurança do Paciente , Complicações Pós-Operatórias/epidemiologia , Convulsões/cirurgia , Síncope/cirurgia , Adulto Jovem
19.
J Laryngol Otol ; 129 Suppl 3: S58-60, 2015 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-25809739

RESUMO

BACKGROUND: A dilemma occurs in the treatment of second-sided Ménière's disease in the only hearing ear, particularly in patients with severe symptoms such as 'drop attacks'. This paper describes a patient treated with contralateral cochlear implantation prior to vestibular nerve section of the symptomatic ear. CASE REPORT: A 53-year-old man, with second-sided Ménière's disease and drop attacks in the only serviceable right ear, underwent successful left cochlear implantation 30 years after hearing loss, followed by right vestibular nerve section. The patient achieved control of Ménière's attacks and improved hearing. Although the patient experienced oscillopsia post-operatively, he was satisfied with his improved everyday functioning. CONCLUSION: Patients with severe second-sided Ménière's disease in the only hearing ear are a small but difficult treatment group. In those that are suitable for cochlear implantation in the non-serviceable ear, it is suggested that this be employed prior to surgical treatment of the Ménière's symptoms, even if the implanted ear has had no auditory stimulation for many years.


Assuntos
Implante Coclear/métodos , Orelha Interna/cirurgia , Doença de Meniere/patologia , Doença de Meniere/cirurgia , Síncope/cirurgia , Nervo Vestibular/cirurgia , Audiometria , Perda Auditiva Neurossensorial/diagnóstico , Perda Auditiva Neurossensorial/etiologia , Perda Auditiva Neurossensorial/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Vertigem/diagnóstico
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