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Selective Vestibular Ablation by KTP Laser in Endolymphatic Hydrops
Author(s) -
Adamczyk Melanie,
Antonelli Patrick J.
Publication year - 2001
Publication title -
the laryngoscope
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.181
H-Index - 148
eISSN - 1531-4995
pISSN - 0023-852X
DOI - 10.1097/00005537-200106000-00023
Subject(s) - medicine , endolymphatic hydrops , endolymphatic sac , ablation , surgery , vertigo , semicircular canal , ophthalmology , vestibular system , anatomy , audiology , inner ear , meniere's disease
Objectives and Hypothesis Vertigo, the cause of disability in many patients with Ménière's disease, may be the result of the effects of endolymphatic hydrops on the semicircular canals. We hypothesize that intractable vertigo may be controlled by destruction of the semicircular canal neuroepithelium using visible light lasers without the need for extensive fenestration of the bony labyrinth. This study was designed to assess the cochlear effects of potassium titanyl phosphate (KTP) laser‐assisted triple semicircular canal ablation (TSCA) in endolymphatic hydrops. Study Design Randomized, prospective, and controlled. Methods Forty‐one adult guinea pigs underwent either a unilateral endolymphatic duct occlusion to induce hydrops or a sham procedure. Ten weeks after induction of the hydrops, a KTP laser‐assisted TSCA or a sham surgery was performed. Results Electrocochleographic thresholds to clicks and tone‐bursts (2–20 kHz) did not change significantly up to 4 weeks after TSCA in hydropic ears. Cross‐sectional histology confirmed the presence of hydrops and the ablation of the semicircular canals. Cochlear whole‐mounts for hair cell counts showed no significant loss of outer or inner hair cells in hydropic ears treated with TSCA. Conclusion KTP laser‐assisted TSCA can be performed in the guinea pig model of endolymphatic hydrops without significant loss of hearing. Evaluation of this technique may be warranted in patients with intractable Ménière's disease.