Cochlear implantation in bilateral Ménière’s disease. A case report
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.
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Amoodi HA, Mick PT, Shipp DB, et al. The effects of unilateral cochlear implantation on the tinnitus handicap inventory and the influence on quality of life. Laryngocope. 2011;121:1536-40. https://doi.org/10.1002/lary.21851
Anderson JP, Harris JP. Impact of Ménière`s disease on quality of life. Otol Neurotol. 2001;22:888-94. https://doi.org/10.1097/00129492-200111000-00030
Arndt S, Aschendorff A, Laszig R, et al. Comparison of pseudobinaural hearing to real binaural hearing rehabilitation after cochlear implantation in patients with unilateral deafness and tinnitus. Otol Neurotol. 2011;32:39-47. https://doi.org/10.1097/MAO.0b013e3181fcf271
Batuecas-Caletrío A, Klumpp M, Santa Cruz-Ruiz S, Benito-González F, González-Sánchez E, Arriaga M. Vestibular function in cochlear implantation: Correlating objectiveness and subjectiveness. Laryngoscope 2015;125:2371-5. https://doi.org/10.1002/lary.25299
Belinchon A, Peres-GarriguesH,Tenias JM. Evolution of symptoms in Ménière´s disease. Audiol Neurotol. 2012;17:126-32. https://doi.org/10.1159/000331945
Clemmens C, Ruckenstein M. Characteristics of patientswith unilateral and bilateral Ménière´s disease. Otol Neurotol. 2012; 33:1266-9. https://doi.org/10.1097/MAO.0b013e31826426b9
Committee on Hearing and Equilibrium. Committee on hearing and equilibrium guidelines for the diagnosis and evaluation of therapy in Ménière's disease. Otolaryngol Head Neck Surg. 1995;113:181-5. https://doi.org/10.1016/S0194-5998(95)70102-8
Douglas A Chen, Fred H. Linthicum JR, Frankin M Ritzer. Cochlear histopathology in the labyrinthectomized ear: implications for cochlear implantation. Laryngoscope. 1988;98:1170-2. https://doi.org/10.1288/00005537-198811000-00004
Eddington DK, Dobelle WG, Brackmann DE, Mladejovsky MG, Parkin JL. Auditory prostheses research with multiple cannel intracochlear stimulation in man. Ann Otol Rhinol Laryngol [Suppl]. 1978;53:1-39.
Fukuoka H, Tsukada K, Miyagawa M, et al. Semi- quantitative evaluation of endolymphatic hydrops by bilateral intratympanic gadolinium-based contrast agent administration with MRI for Ménière´s disease. Acta Otolaryngol. 2009;10:1-7. https://doi.org/10.1080/00016480902858881
Green JD, Blum DJ, Harner SG. Longitudinal followup of patients with Ménière´s disease. Otolaryngol Head Neck Surg 1991;104:783-8. https://doi.org/10.1177/019459989110400603
Hallpike CS, Cairns H. Observations on the pathology of Ménière's syndrome: (Section of Otology). Proc R Soc Med. 1938;31:1317-36. https://doi.org/10.1017/s0022215100003947
Iseli C, Gibson W. A comparison of three methods of using transtympanic electrocochleography for diagnosis of Ménière´s disease. Acta Otolaryngol. 2009;26:1-8. https://doi.org/10.1080/00016480902858899
Kentala E, Havia M, Pykko I, Short-lasting drop attacks in Ménière's disease. Otolaryngol Head Neck Surg. 2001;124:526-30. https://doi.org/10.1067/mhn.2001.115169
Kotimaki J, Sorri M, Aantaa E, Nuutinen J. Prevalence of Meniére's disease in Finland. Laryngoscope. 1999;109:748-53. https://doi.org/10.1097/00005537-199905000-00013
Kveton JF, Abbott C, April M, Drumheller G, Cohen N, Poe DS. Cochlear implantation after transmastoid labyrinthectomy. Laryngoscope. 1989;99:610-613. https://doi.org/10.1288/00005537-198906000-00008
Lin MY, Timmer FC, Oriel BS et al. Vestibular evoked myogenic potencials (VEMP) can detect asymptomtic saccular hydrops. Laryngoscope. 2006;116:987-92. https://doi.org/10.1097/01.mlg.0000216815.75512.03
Lustig LR, Yeagle J, Niparko JK, Minor LB. Cochlear implantation in patients with bilateral Ménière's syndrome. Otol Neurotol. 2003;24:397-403. https://doi.org/10.1097/00129492-200305000-00009
Mancini F, Catalani M, Carru M, Monti B. History of Ménière's disease and its clinical presentation. Otolaryngol Clin North Am. 2002;35:565-80. https://doi.org/10.1016/S0030-6665(02)00017-8
Marlan R, Hansen, Bruce J. Gantz and Camille Dunn. Outcomes following cochlear implantation for patients with single-sided deafness, including those with recalcitrant Ménière's disease. Otol Neurotol. 2013;34:1681-7. https://doi.org/10.1097/MAO.0000000000000102
McRackan T.R, Gifford R.N, Kahue C.H, Dwyer R, Labadie R.F, Wanna G.B, Haynes D.S, Bennett M.L. Cochlear Implantation in Ménière's Disease Patients. Otol Neurotol. 2014;35:421-5. https://doi.org/10.1097/MAO.0000000000000247
Mick P, Amoodi H, Arnoldner C. Cochlear implantation in patients with advanced Ménière’s disease. Otol Neurotol. 2014;35:1172-8.
Nadol J. Histologic considerations in implant patients. Arch Otolayngol Head Neck Surg. 1984;1:60-3.
Nakee K, Komatuzaki K. Epidemiological study of Ménière's disease. Pract Otol (Kyoto). 1984;69:1783-8. https://doi.org/10.5631/jibirin.69.11special_1783
Nguyen KD, Minor LB, Delia Santina CC et al. Vestibular function and vertigo control after intratympanic gentamicin for Ménière's disease. Audiol Neurotol. 2009:14:361-72. https://doi.org/10.1159/000241893
Osborn HA. Yeung R, Lin VY. Delayed cochlear implantation after surgical labyrinthectomy. J Laryngol Otol. 2012;126:63-5. https://doi.org/10.1017/S0022215111002374
Paparella MM, Griebie MS. Bilaterality of Ménière's disease. Acta Otolaryngol (Stockh). 1984;97:233-7. https://doi.org/10.3109/00016488409130984
Pérez Fernández N, Montes Jovellar L, Cervera Paz J et al. Auditory and vestibular assessment of patients with Meniere's disease who suffer Tumarkin attacks. Audiol Neurotol. 2010;15:399-406. https://doi.org/10.1159/000310899
Ravi N. Samy, Lisa Houston, Michael Scott, Daniel I. Cochlear implantation in patients with Ménière's Disease. Cochlear Implants Int. 2015;16:208-12. https://doi.org/10.1179/1754762814Y.0000000104
Rubinstein JT, Parkinson WS, Tyler RS, et al. Residual speech recognition and cochlear implant performance: effects of implantation criteria. Am J Otol. 1999;20: 445-52.
Samuel A. C. MacKeith, MBChB, FRCS, Ian D. Bottrill, MBBS, FRCS, James D. Ramsden, FRCS. Simultaneous Labyrinthectomy With Cochlear Implantation in Patients With Bilateral Ménière's Disease. Ann Otol Rhinol Laryngol. 2014;123:485–9. https://doi.org/10.1177/0003489414527226
Shojaku H, Watanabe Y, Mizukoshi K, et al. Epidemiological study of severe cases of Ménière's disease in Japan. Acta Otolaryngol Suppl. 1995;520:415-8. https://doi.org/10.3109/00016489509125286
Stahle J, Stahle C, Anerberg IK. Incidence of Ménière's disease. Arch Otolaryngol. 1978;104:99-102. https://doi.org/10.1001/archotol.1978.00790020041009
Stahle J. Advanced Ménière's disease.A study of 356 severely disabled patients. Acta Otolaryngol. 1976;31:113-9. https://doi.org/10.3109/00016487609107484
Teufert KB, Doherty J. Endolymphatic sac shunt, labyrinthectomy and vestibular nerve section in Ménière's disease. Otolaryngol Clin North Am. 2010;43:1091-111. https://doi.org/10.1016/j.otc.2010.05.014
Tien HC, Linthicum FH. Histopathologic changes in the vestibule after cochlear implantation. Otolaryngol Head Neck Surg. 2002;127:260-4. https://doi.org/10.1067/mhn.2002.128555
Tokumaau K, Tashiro N, Goto K, et al. Incidence and prevalence of Ménière's disease in Aagamihara City, Kanagawaken. Pract Otol (Kyoto). 1983;1:1165-75.
Waltzman SB, Cosetti MK. Outcomes in cochlear implantation: variables affecting performance in adults and children. Otolaryngol Clin North Am. 2012;45:155-71. https://doi.org/10.1016/j.otc.2011.08.023
Zwolan T.A, Sheoard N.T and Niparko J.K. Labyrinthectomy with cochlear implantation. Am J Otol. 1993;14:220-3.
Anderson JP, Harris JP. Impact of Ménière`s disease on quality of life. Otol Neurotol. 2001;22:888-94. https://doi.org/10.1097/00129492-200111000-00030
Arndt S, Aschendorff A, Laszig R, et al. Comparison of pseudobinaural hearing to real binaural hearing rehabilitation after cochlear implantation in patients with unilateral deafness and tinnitus. Otol Neurotol. 2011;32:39-47. https://doi.org/10.1097/MAO.0b013e3181fcf271
Batuecas-Caletrío A, Klumpp M, Santa Cruz-Ruiz S, Benito-González F, González-Sánchez E, Arriaga M. Vestibular function in cochlear implantation: Correlating objectiveness and subjectiveness. Laryngoscope 2015;125:2371-5. https://doi.org/10.1002/lary.25299
Belinchon A, Peres-GarriguesH,Tenias JM. Evolution of symptoms in Ménière´s disease. Audiol Neurotol. 2012;17:126-32. https://doi.org/10.1159/000331945
Clemmens C, Ruckenstein M. Characteristics of patientswith unilateral and bilateral Ménière´s disease. Otol Neurotol. 2012; 33:1266-9. https://doi.org/10.1097/MAO.0b013e31826426b9
Committee on Hearing and Equilibrium. Committee on hearing and equilibrium guidelines for the diagnosis and evaluation of therapy in Ménière's disease. Otolaryngol Head Neck Surg. 1995;113:181-5. https://doi.org/10.1016/S0194-5998(95)70102-8
Douglas A Chen, Fred H. Linthicum JR, Frankin M Ritzer. Cochlear histopathology in the labyrinthectomized ear: implications for cochlear implantation. Laryngoscope. 1988;98:1170-2. https://doi.org/10.1288/00005537-198811000-00004
Eddington DK, Dobelle WG, Brackmann DE, Mladejovsky MG, Parkin JL. Auditory prostheses research with multiple cannel intracochlear stimulation in man. Ann Otol Rhinol Laryngol [Suppl]. 1978;53:1-39.
Fukuoka H, Tsukada K, Miyagawa M, et al. Semi- quantitative evaluation of endolymphatic hydrops by bilateral intratympanic gadolinium-based contrast agent administration with MRI for Ménière´s disease. Acta Otolaryngol. 2009;10:1-7. https://doi.org/10.1080/00016480902858881
Green JD, Blum DJ, Harner SG. Longitudinal followup of patients with Ménière´s disease. Otolaryngol Head Neck Surg 1991;104:783-8. https://doi.org/10.1177/019459989110400603
Hallpike CS, Cairns H. Observations on the pathology of Ménière's syndrome: (Section of Otology). Proc R Soc Med. 1938;31:1317-36. https://doi.org/10.1017/s0022215100003947
Iseli C, Gibson W. A comparison of three methods of using transtympanic electrocochleography for diagnosis of Ménière´s disease. Acta Otolaryngol. 2009;26:1-8. https://doi.org/10.1080/00016480902858899
Kentala E, Havia M, Pykko I, Short-lasting drop attacks in Ménière's disease. Otolaryngol Head Neck Surg. 2001;124:526-30. https://doi.org/10.1067/mhn.2001.115169
Kotimaki J, Sorri M, Aantaa E, Nuutinen J. Prevalence of Meniére's disease in Finland. Laryngoscope. 1999;109:748-53. https://doi.org/10.1097/00005537-199905000-00013
Kveton JF, Abbott C, April M, Drumheller G, Cohen N, Poe DS. Cochlear implantation after transmastoid labyrinthectomy. Laryngoscope. 1989;99:610-613. https://doi.org/10.1288/00005537-198906000-00008
Lin MY, Timmer FC, Oriel BS et al. Vestibular evoked myogenic potencials (VEMP) can detect asymptomtic saccular hydrops. Laryngoscope. 2006;116:987-92. https://doi.org/10.1097/01.mlg.0000216815.75512.03
Lustig LR, Yeagle J, Niparko JK, Minor LB. Cochlear implantation in patients with bilateral Ménière's syndrome. Otol Neurotol. 2003;24:397-403. https://doi.org/10.1097/00129492-200305000-00009
Mancini F, Catalani M, Carru M, Monti B. History of Ménière's disease and its clinical presentation. Otolaryngol Clin North Am. 2002;35:565-80. https://doi.org/10.1016/S0030-6665(02)00017-8
Marlan R, Hansen, Bruce J. Gantz and Camille Dunn. Outcomes following cochlear implantation for patients with single-sided deafness, including those with recalcitrant Ménière's disease. Otol Neurotol. 2013;34:1681-7. https://doi.org/10.1097/MAO.0000000000000102
McRackan T.R, Gifford R.N, Kahue C.H, Dwyer R, Labadie R.F, Wanna G.B, Haynes D.S, Bennett M.L. Cochlear Implantation in Ménière's Disease Patients. Otol Neurotol. 2014;35:421-5. https://doi.org/10.1097/MAO.0000000000000247
Mick P, Amoodi H, Arnoldner C. Cochlear implantation in patients with advanced Ménière’s disease. Otol Neurotol. 2014;35:1172-8.
Nadol J. Histologic considerations in implant patients. Arch Otolayngol Head Neck Surg. 1984;1:60-3.
Nakee K, Komatuzaki K. Epidemiological study of Ménière's disease. Pract Otol (Kyoto). 1984;69:1783-8. https://doi.org/10.5631/jibirin.69.11special_1783
Nguyen KD, Minor LB, Delia Santina CC et al. Vestibular function and vertigo control after intratympanic gentamicin for Ménière's disease. Audiol Neurotol. 2009:14:361-72. https://doi.org/10.1159/000241893
Osborn HA. Yeung R, Lin VY. Delayed cochlear implantation after surgical labyrinthectomy. J Laryngol Otol. 2012;126:63-5. https://doi.org/10.1017/S0022215111002374
Paparella MM, Griebie MS. Bilaterality of Ménière's disease. Acta Otolaryngol (Stockh). 1984;97:233-7. https://doi.org/10.3109/00016488409130984
Pérez Fernández N, Montes Jovellar L, Cervera Paz J et al. Auditory and vestibular assessment of patients with Meniere's disease who suffer Tumarkin attacks. Audiol Neurotol. 2010;15:399-406. https://doi.org/10.1159/000310899
Ravi N. Samy, Lisa Houston, Michael Scott, Daniel I. Cochlear implantation in patients with Ménière's Disease. Cochlear Implants Int. 2015;16:208-12. https://doi.org/10.1179/1754762814Y.0000000104
Rubinstein JT, Parkinson WS, Tyler RS, et al. Residual speech recognition and cochlear implant performance: effects of implantation criteria. Am J Otol. 1999;20: 445-52.
Samuel A. C. MacKeith, MBChB, FRCS, Ian D. Bottrill, MBBS, FRCS, James D. Ramsden, FRCS. Simultaneous Labyrinthectomy With Cochlear Implantation in Patients With Bilateral Ménière's Disease. Ann Otol Rhinol Laryngol. 2014;123:485–9. https://doi.org/10.1177/0003489414527226
Shojaku H, Watanabe Y, Mizukoshi K, et al. Epidemiological study of severe cases of Ménière's disease in Japan. Acta Otolaryngol Suppl. 1995;520:415-8. https://doi.org/10.3109/00016489509125286
Stahle J, Stahle C, Anerberg IK. Incidence of Ménière's disease. Arch Otolaryngol. 1978;104:99-102. https://doi.org/10.1001/archotol.1978.00790020041009
Stahle J. Advanced Ménière's disease.A study of 356 severely disabled patients. Acta Otolaryngol. 1976;31:113-9. https://doi.org/10.3109/00016487609107484
Teufert KB, Doherty J. Endolymphatic sac shunt, labyrinthectomy and vestibular nerve section in Ménière's disease. Otolaryngol Clin North Am. 2010;43:1091-111. https://doi.org/10.1016/j.otc.2010.05.014
Tien HC, Linthicum FH. Histopathologic changes in the vestibule after cochlear implantation. Otolaryngol Head Neck Surg. 2002;127:260-4. https://doi.org/10.1067/mhn.2002.128555
Tokumaau K, Tashiro N, Goto K, et al. Incidence and prevalence of Ménière's disease in Aagamihara City, Kanagawaken. Pract Otol (Kyoto). 1983;1:1165-75.
Waltzman SB, Cosetti MK. Outcomes in cochlear implantation: variables affecting performance in adults and children. Otolaryngol Clin North Am. 2012;45:155-71. https://doi.org/10.1016/j.otc.2011.08.023
Zwolan T.A, Sheoard N.T and Niparko J.K. Labyrinthectomy with cochlear implantation. Am J Otol. 1993;14:220-3.
Moreno-Bravo, A., Sánchez-Gómez, H., Aguilera-Aguilera, G. A., González-Sánchez, M., Santa Cruz-ruiz, S., & Batuecas-Caletrío, Ángel. (2017). Cochlear implantation in bilateral Ménière’s disease. A case report. Revista ORL, 8(1), 53–60. https://doi.org/10.14201/orl.14699
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