Document Detail


Triple semicircular canal occlusion in guinea pigs with endolymphatic hydrops.
MedLine Citation:
PMID:  16371851     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
HYPOTHESIS: Triple semicircular canal occlusion will eliminate rotatory stimulation to the vestibular peripheral system (as it blocks endolymphatic fluid movement) and therefore release rotatory vertigo attack. This surgery is safe in ears with endolymphatic hydrops. BACKGROUND: Semicircular canal occlusion has been used as an alternative treatment of intractable benign paroxysmal positional vertigo with varied success. Triple semicircular canal occlusion in animal models blocks the responses of the semicircular canals to rotation and spares cochleae and the otolithic apparatus. This result suggests that triple semicircular canal occlusion is a prospective method in vertigo management for patients with Ménière's disease. However, the effectiveness and safety of triple semicircular canal occlusion has not been fully evaluated in ears with endolymphatic hydrops. METHODS: Endolymphatic hydrops was established in 20 guinea pigs by endolymphatic sac obliteration. Triple semicircular canal occlusion was performed in 12 of them 120 days after endolymphatic hydrops surgery, whereas 8 others were killed for morphologic observation to confirm endolymphatic hydrops. Auditory and vestibular functions were monitored from the time before endolymphatic hydrops until 1 month after triple semicircular canal occlusion. Endolymphatic hydrops and canal occlusion were confirmed by morphologic observation. RESULTS: Successful establishment of endolymphatic hydrops was indicated by mild elevation of the auditory brainstem response threshold and tentative asymmetry in nystagmus. Endolymphatic hydrops was confirmed by cochlear morphology in all eight animals that were killed 120 days after endolymphatic hydrops surgery. After triple semicircular canal occlusion, all 12 animals showed spontaneous nystagmus with a slow component toward the side that had been operated on, head tilt, rotated walking, and tentative asymmetry in rotatory nystagmus. The static symptoms disappeared within 1 month after triple semicircular canal occlusion. Caloric nystagmus was only slightly reduced after endolymphatic hydrops as compared with the contralateral ears but could not be elicited at all after triple semicircular canal occlusion. No significant elevation in auditory brainstem response threshold was found after triple semicircular canal occlusion. The canal occlusion and endolymphatic hydrops were confirmed in all surgical ears. CONCLUSION: Triple semicircular canal occlusion is effective for eliminating the response of semicircular canals to rotation and caloric stimulation and is safe in ears with endolymphatic hydrops. Also, the static compensation to the disequilibrium is quick and complete. These results suggest that triple semicircular canal occlusion should be an option for controlling rotatory vertigo in Ménière's disease.
Authors:
Shankai Yin; Dongzhen Yu; Manna Li; Jian Wang
Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology     Volume:  27     ISSN:  1531-7129     ISO Abbreviation:  Otol. Neurotol.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2005-12-22     Completed Date:  2006-08-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  100961504     Medline TA:  Otol Neurotol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  78-85     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology, Affiliated Sixth People's Hospital, Shanghai Jiao Tong University, Shanghai, China.
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MeSH Terms
Descriptor/Qualifier:
Animals
Disease Models, Animal
Endolymphatic Hydrops / complications,  surgery*
Evoked Potentials, Auditory, Brain Stem
Female
Guinea Pigs
Male
Nystagmus, Physiologic
Semicircular Canals / surgery*
Treatment Outcome
Vertigo / etiology,  surgery*
Vestibule, Labyrinth / physiology

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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