Labyrinthectomy

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A labyrinthectomy is a destructive procedure used for Ménière’s disease. The balance end organs are removed so that the brain no longer receives signals from the parts of the inner ear that sense … Read More

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Labyrinthectomy

Labyrinthectomy is a medical surgery which is performed to treat vertigo. It is the last option left when you are not able to hear properly after use of hearing aid. This process aims to end vestibular function. It lessens the symptoms related to vertigo. It can be done to treat Meniere’s disease. 

Meniere’s disease

The disease has a long-lasting and severe effect on the quality of your life. Vertigo is an internal and external spinning sensation caused by the movement of the head quickly. These are very often and unpredictable. It can cause permanent hearing loss. These conditions can result in frequent accidents.  Some common symptoms involve dizziness, loss of hearing, pressure on the ear during the hearing, ringing in the ear, imbalance, nausea, motion sickness, eye movements involuntarily, and a sense of fullness in the ear. The causes of this disease are certain allergies, it can occur due to inheritance and auto-immune diseases. It can be prevented by avoiding intake of excessive chocolate, caffeine, consumption of alcohol, monosodium glutamate, and excessive intake of salt. Also one must drink sufficient water that is almost 6-8 glasses to avoid such problems. It is a very rare disease. Labyrinthectomy can be done to cure Meniere’s disease though it acts as the last resort to rectify the disorder.  

How to diagnose Meniere’s disease

The diagnosis is simple. The hearing tests are done during which headphones are used to check whether the patient is able to hear noises at different pitches and frequencies. Eye tests are conducted to scrutinize the movement.

Labyrinthectomy procedure

This surgery is conducted with an aim to destroy either balance or hearing or both simultaneously and to reverse the pressure of the high fluid. It is a procedure that eliminates the hearing and the vestibular function of the ear. It can be done either by removing the bone and all of the labyrinth or by unfolding the ear and eliminating a few of the soft tissues. The success rate of labyrinthectomy ranges from 95 percent to 98 percent. Labyrinthectomy should not be offered to a person who has good hearing in the affected ear as it destroys the hearing function and can cause permanent deafness.

Labyrinthectomy surgery

During the process, general anesthesia is administered to numb the pain or discomfort. The doctor removes the inner ear area which results in the balance of the ear. The surgery is very effective and reduces vertigo to negligible. However, this process is avoided in patients with normal hearing. It is beneficial to perform this process only if the indications are severe and medications have failed to show any relief. After the surgery, the rest for recovery is must as the patient will be under the effect of anaesthesia for a few hours. The patient may need to stay overnight or for 2-3 days for observation. Though you can experience unsteadiness for many weeks. The life after surgery can be a difficult but healthy diet, prescriptions from the doctor and regular exercises may help in long-lasting benefits. 

What is removed with a Labyrinthectomy?

The parts that are removed during Labyrinthectomy are vestibular Labyrinth, otolith organ that is saccule and utricle and crista ampullary of the superior semicircular canal.  

Benefits of Labyrinthectomy

The benefits of labyrinthectomy are that it is a painless procedure, the success rate is extremely high and most patients experience relief after the procedure. The most important feature is that it is easily available and pocket friendly.

Side effects of Labyrinthectomy

Some complications are vomiting, nerve injury of the face, sometimes symptoms do not disappear entirely resulting in the return of the disease, loss of balance function in the treated ear, leakage of cerebrospinal fluids, total loss of hearing and nausea.

Bilateral Labyrinthectomy

Bilateral vestibular dysfunction is defined as the absence or reduction of the functions of the vestibular part of both sides which occurs as a result of depletion in the labyrinth or vestibular or both. This depletion can be full or partial. Generally, reduction of the entire vestibular part in the inner ear like gentamicin, damage of horizontal semicircular canals known as bilateral vestibular neuritis and ototoxicity are found in the patients diagnosed with bilateral vestibular dysfunction. 

Problems of bilateral vestibular dysfunction

Normally people having bilateral vestibular loss experience extreme imbalance which is a very common indication. In this, the brain tries to repay for the depletion by depending on the vision left and internal calculations. The condition leads to poor navigation through translucent climate and steps through the spongy surfaces are very difficult. The other problems that develop are joint prostheses, cataracts and neuropathy. Their mental health is also affected as a result of these disorders. It is to be known that tinnitus and loss of hearing are not common among patients of bilateral vestibular loss. It occurs because the origins of this disorder do not affect hearing. Though meningitis and Cogan’s syndrome can develop. 
  • Meningitis- the disorder results in the destruction of vestibular function and damaged hearing. In the case of severe loss of hearing there is a greater chance of bilateral vestibular function loss. The vestibular aqueducts are most common in children as compared to adults. As labyrinth comes to be ossified, the vestibular function deliberately destroys over time. In order to not miss any labyrinth because of the orientation of the cut one should look at many sections. 
  • Bilateral vestibular neuritis- normally, the vestibular nerve is affected by bilateral vestibular neuritis. Sometimes the inferior nerve is also included though it is rare and it usually accompanies Ramsay Hunt syndrome. The diagnosis can be done using the tendency of vestibular neuritis to limit the inferior vestibular nerve. 

Diagnosis of bilateral vestibular dysfunction 

The diagnosis can be done using several techniques such as rotator chair, Videonystagmography, ophthalmoscope test, bedside test, vestibular provoked myogenic potentials and computerized dynamic posturography. 

Treatment for bilateral vestibular dysfunction 

Treatment is beneficial if the source of dysfunction is known and direct actions are necessary. It is a very rare condition to know the origin of this disorder and it is even rarer to recognize a curable reason for a bilateral vestibular loss like autoimmune of the inner ear.  Vestibular rehabilitation therapy- this therapy is helpful in almost all cases of bilateral vestibular dysfunction. Due to the loss of vestibular sensory input, the patient experiences difficulties so this therapy neutralizes the loss. It is recommended to abstain from vestibular suppressants and other drugs too to prevent side effects as these worsen the condition of vestibular dysfunction. Normally, activating antidepressants are preferred over sedating antidepressants. The commonly recommended drug for reducing comfort and anxiety is Benzodiazepines. Though its regular intake can be dangerous as it represses the functions of the vestibular part. 

Symptoms

• Feeling nauseated.
• Vomiting.
• Abnormal or jerking eye movements (nystagmus)
• Headache.
• Sweating.
• Ringing in the ears or hearing loss.

Causes

• The balance end organs are removed so that the brain no longer receives signals from the parts of the inner ear that sense gravity and motion changes.
• The hearing organ (cochlea) is also sacrificed with this procedure.

FAQ

What is the cost of the labyrinthectomy surgery?

The cost of Labyrinthectomy is not expensive at all. It is easily available and affordable. Its range starts from $10 and differs according to the severity of the problem, medical facilities and other hospital charges. 

How long does Labyrinthectomy take to be completed? 

Labyrinthectomy surgery normally lasts for 2 hours plus recovery takes further 3-4 hours. After the Labyrinthectomy surgery, regular visits may be required for medical purposes. 

How to prepare for Labyrinthectomy surgery?

The patient must be accompanied by someone to help after surgery, one must abstain from all medications before the surgery and should follow routine and diet as prescribed by the doctor.

What does Labyrinthectomy treat?

Labyrinthectomy cures Meniere’s disease. It is defined by the dizziness and sudden spinning of the head along with random movements of the eyes. Though the procedure is considered to be the last option for the treatment. 

Is Labyrinthectomy painful? If yes, how much?

No, labyrinthectomy is not painful. Anaesthesia is injected in the body of the patient to avoid the feeling of discomfort or pain during the surgery. However, during recovery slight discomfort is common.