Contenido principal del artículo

Ainhoa Moreno-Bravo
Complejo Hospitalario de Mérida. Badajoz
España
Biografía
Hortensia Sánchez-Gómez
Complejo Asistencial Universitario de Salamanca. Salamanca
España
Biografía
Gabriel Alejandro Aguilera-Aguilera
Complejo Asistencial Universitario de Salamanca. Salamanca
España
Biografía
Myriam González-Sánchez
Complejo Asistencial de Zamora. Zamora
España
Biografía
Santiago Santa Cruz-ruiz
Complejo Asistencial Universitario de Salamanca. Salamanca
España
Biografía
Ángel Batuecas-Caletrío
Complejo Asistencial Universitario de Salamanca. Salamanca
España
Biografía
Vol. 8 Núm. 1 (2017), Caso clínico, Páginas 53-60
DOI: https://doi.org/10.14201/orl.14699
Cómo citar

Resumen

Introducción: La enfermedad de Ménière se caracteriza por síntomas cocleares y vestibulares. Puede ser unilateral o bilateral. Cuando la pérdida de audición asociada es severa-profunda de forma bilateral o unilateral pero con problemas de audición en el otro oído, dicha audición puede beneficiarse de un implante coclear. Si además, presenta crisis de vértigo y Tumarkin refractarias al tratamiento médico, se puede plantear la realización simultánea de una laberintectomía quirúrgica y colocación de un implante coclear. Descripción: Se describe el caso de un paciente con enfermedad de Ménière bilateral con hipoacusia neurosensorial profunda de oído derecho con fluctuaciones auditivas izquierdas que asocia crisis vertiginosas y de Tumarkin sin respuesta a corticoides orales e intratimpánicos ni a gentamicina intratimpánica. Se le realizó una laberintectomía quirúrgica con implante coclear en el mismo acto quirúrgico anticipándonos al probable deterioro auditivo contralateral. Posteriormente presenta buen rendimiento del implante y desaparición de las crisis del oído intervenido. Discusión: El objetivo del tratamiento es controlar las crisis preservando la función, pero en pacientes en los que las medidas conservadoras fallan, se han de considerar otras más destructivas como es la laberintectomía química, que consigue altas tasas de control de las crisis, y el implante coclear, indicado para restaurar la audición en el oído afectado por enfermedad de Ménière. Si ambas se realizan en un mismo tiempo quirúrgico, se consigue reducir riesgos asociados con otros procedimientos quirúrgicos y anestésicos y evitar las modificaciones histológicas tras una laberintectomía química que dificultarían la posterior colocación del implante colear.

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