Implante coclear en enfermedad de Ménière bilateral. Descripción de un caso

Abstract

Introduction and objective: Ménière’s disease (MD) is an episodic vestibular syndrome associated with sensorineural hearing loss and tinnitus. It may be unilateral or bilateral. Cochlear implantation (CI) could be considered in MD patients if a profound hearing loss is showed in both ears. As alternative, it should be valued if profound hearing loss affects only one ear but the contralateral is affected too. When a MD patient suffers from vertigo spells or otolitic crisis of Tumarkin appart from the profound hearing loss, a simultaneous surgical labyrinthectomy and CI procedure could be considered. Description: Bilateral MD patient with right profound hearing loss and left fluctuating moderate hearing loss. No response was observed after oral and intratympanic steroids and intratympatic gentamicin in the treatment of right ear. A cochlear implantation and classic labyrinthectomy were performed at the same time in the right ear. No new vertigo spells or otolitic crisis of Tumarkin appeared after three months of follow up. Discussion: The objective in the treatment of MD is to get the control of vertigo spells and a hearing preservation. When conservative treatment is not useful, the gold standard is the labyrinthectomy (gentamicin or classic labyrinthectomy). The surgical labyrinthectomy could be accompanied by cochlear implantation to restore hearing in this ear. To perform both surgical labyrinthectomy and cochlear implantation simultaneously should be considered in order to reduce anesthesic ricks and cochlear histological changes after labyrinthectomy.