Middle Ear Pressure and Dysfunction of the Labyrinth: Is There a Relationship?
Department of Otorhinolaryngology, University of Freiburg, Germany.The Annals of otology, rhinology, and laryngology (Impact Factor: 1.09). 07/1997; 106(6):478-82. DOI: 10.1177/000348949710600607
Relationships between middle ear pressure and non-infection-related cochleovestibular dysfunction have been suggested by several authors. According to some data, vertiginous attacks can be prevented by the insertion of a ventilation tube in patients suffering from Meniere's syndrome. The aim of our study was to investigate if the incidence of eustachian tube malfunction and pathologic middle ear pressure is frequent, and if routine implantation of ventilation tubes is reasonable in ears with dysfunctions of the labyrinth, including clinical Meniere's syndrome. So, we determined in our pressure chamber all active and passive parameters of eustachian tube function in 40 patients suffering from Meniere's syndrome, sudden sensory hearing impairment (SSHI), or vestibular neuronitis. Our results disclosed no nonrandom incidence of impaired tubal function among our patients compared to healthy control subjects. Pressure equalization was sufficient in most patients suffering from clinical Meniere's syndrome, and only one patient with vestibular neuronitis presented with a patulous tube. Our results show that impairment of vestibular or cochlear function is not regularly accompanied by eustachian tube dysfunction. Furthermore, no patient reported symptoms while pressure variation was performed. We conclude that variation of middle ear pressure does not usually play a role in the genesis of Meniere's syndrome, vestibular neuronitis, or SSHI. Thus, from our data, we cannot recommend routine implantation of tympanic ventilation tubes in patients suffering from Meniere's syndrome, vestibular neuronitis, or sudden hearing loss.
- [Show abstract] [Hide abstract]
ABSTRACT: A prospective, randomized study was carried out comparing the effect of two surgical modalities in the treatment of patients with Meniere's disease: insertion of an endolymphatic sac shunt and insertion of a ventilating tube in the tympanic membrane. A total of 29 patients, 12 males and 17 females, age 27-71 years, were operated on in two ear, nose and throat (ENT) departments. Of these patients, 15 had an endolymphatic shunt inserted and 14 had a ventilating tube inserted in the tympanic membrane. Postoperative follow-up was carried out in the department in which the patients had not been operated. The severity of the disease was scored pre- and postoperatively, and the results evaluated under the guidelines of the Committee on Hearing and Equilibrium (1995) for the diagnosis and evaluation of therapy in Meniere's disease. The patients in both groups had a statistically significant reduction in dizzy spells, measured 6 and 12 months postoperatively, and there was no difference between the groups. The pathophysiological explanation for the reduction in dizzy spells in each of the treatment modalities is debatable and the effect is non-specific. The patients' hearing and tinnitus were statistically unaffected by the treatment in both groups, though 2 patients in the shunt group developed severe hearing loss (anacusis/70 dB).Acta Oto-Laryngologica 12/1998; 118(6):769-73. · 1.10 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: As a treatment for patients with Meniere's disease, insertion of a ventilating tube in tympanic membrane was carried out, and the effect of the therapeutic modality was analysed. Seven patients (four males and three females, age ranged 35-62 years) with active Meniere's disease were placed with ventilating tubes in the affected ear and postoperative change in symptoms, i.e. incapacitating vertigo and hearing loss were investigated. Disease severity was scored and evaluated pre- and postoperatively under the guidelines proposed by the Committee on Hearing and Equilibrium in the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS, 1985). Of the seven cases, the number of patients and the degree in controlling vertigo after the treatment were: at 24 months (short-term) five cases with substantial, one with limited and one with insignificant control, then at 42 months (long- term) four cases with substantial, three with limited control, respectively. The degree of disability in patients at 24 and 42 months of the treatment was compatible with the level of vertigo controlling. On the other hand, patients' hearing level was not affected by the treatment. Exact explanation for the effect of ventilating tubes in tympanic membrane is vague and its therapeutic effect was limited. However, at least this treatment might represent a short-term effect for the reduction of persistent vertigo in some patients with Meniere's disease and so it might become a treatment option because of its simple and less-invasive procedure.Auris Nasus Larynx 03/2003; 30(1):25-8. DOI:10.1016/S0385-8146(02)00105-0 · 1.14 Impact Factor
- [Show abstract] [Hide abstract]
ABSTRACT: The middle ear pressure was analyzed in 112 patients with dizziness. In 37 patients with Meniere's disease, the middle ear pressure on the low-pressure side was significantly lower, the middle ear pressure difference (between the high and low sides) was significantly larger, and the maximum compliance on the low-compliance side was significantly lower than in normal volunteers. The middle ear pressure difference was significantly larger during periods of dizziness or recurrent dizziness than at the time of remission. In patients with Meniere's disease, a middle ear pressure difference of more than 50 decapascals was significantly more common among those with abnormal blood gas levels than among those with normal blood gas levels. In 27 patients with cervical vertigo and 15 patients with vertebrobasilar insufficiency, the middle ear pressure difference was also significantly larger than in normal volunteers. These results suggest that the middle ear pressure difference might be closely related to dizziness in Meniere's disease and less closely related in cervical vertigo or vertebrobasilar insufficiency. The middle ear pressure difference might also be related to abnormal blood gas levels in patients with dizziness.The Annals of otology, rhinology, and laryngology 12/2004; 113(11):906-13. DOI:10.1177/000348940411301110 · 1.09 Impact Factor
Data provided are for informational purposes only. Although carefully collected, accuracy cannot be guaranteed. The impact factor represents a rough estimation of the journal's impact factor and does not reflect the actual current impact factor. Publisher conditions are provided by RoMEO. Differing provisions from the publisher's actual policy or licence agreement may be applicable.