Successful Treatment for Meniere’s Disease through Vestibular Neurectomy

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Patients with Meniere’s disease (MD) can find relief from vertigo episodes and see improvements in their condition through a procedure known as vestibular neurectomy. This finding was highlighted in a recent study published online on July 30 in Acta Neurologica Belgica.

The study, conducted by Dr. Agnieszka Jasińska-Nowacka and her team from the Medical University of Warsaw in Poland, investigated the effects of vestibular neurectomy on patients with severe MD. Twenty patients with confirmed unilateral Meniere’s disease underwent magnetic resonance imaging (MRI) before and after the surgery to assess the presence of endolymphatic hydrops, which is an abnormal fluid buildup in the inner ear.

In all patients, the preoperative scans showed the presence of endolymphatic hydrops. After the surgery, every patient experienced a complete resolution of their vertigo episodes. The study also found that the hydrops in the cochlea and vestibule regressed in 35% and 15% of cases, respectively. Furthermore, in patients with utricular herniation into the lateral semicircular canal, 71.43% showed withdrawal of the hernia. Additionally, 17.64% of patients saw a regression of asymmetrical contrast enhancement in the cochlea.

Overall, partial regression of at least one radiological sign was observed in 60% of patients during follow-up examinations. Importantly, no progression of endolymphatic hydrops was detected in either the cochlea or the vestibule after the surgery.

“Although it is known to be an effective symptomatic treatment of vertigo attacks, vestibular neurectomy may also effectively halt the progression of the endolymphatic space dilatation and result in hydrops regression,” the authors concluded.

Meniere’s disease is a condition affecting the inner ear, causing episodes of vertigo, hearing loss, tinnitus (ringing in the ears), and a feeling of fullness or pressure in the ear. The exact cause of Meniere’s disease is not well understood, but it is thought to be related to abnormal fluid buildup in the inner ear. Common symptoms include sudden episodes of severe dizziness, fluctuating hearing loss, ringing in the ears, and a sensation of fullness in the ear.

Treatment for Meniere’s disease includes medications to reduce vertigo symptoms, such as anti-nausea drugs and motion sickness medications. In some cases, diuretics (water pills) may be prescribed to reduce fluid retention. Vestibular rehabilitation therapy can help improve balance. In severe cases, surgical options like vestibular neurectomy or even procedures to reduce fluid in the inner ear may be considered. Alternative treatments include acupuncture, herbal remedies, and dietary changes to manage symptoms.

Key Insights:

  • Vestibular neurectomy effectively resolves vertigo episodes in patients with severe Meniere’s disease.
  • The surgery leads to a regression of endolymphatic hydrops in a significant number of patients.
  • Follow-up examinations show no progression of the condition post-surgery.
  • Meniere’s disease symptoms include vertigo, hearing loss, tinnitus, and ear fullness.
  • Treatment options range from medications and rehabilitation therapy to surgical interventions and alternative treatments.

Source: Acta Neurologica Belgica

 


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