ENDOLYMPHATIC SAC SURGERY Risks and Complications

Total Page：16

File Type：pdf, Size：1020Kb

ENDOLYMPHATIC SAC SURGERY Risks and Complications Your condition may be helped by an operation to remove the bone over the endolymphatic sac, the reservoir that holds the fluid of the inner ear. As with any surgery there are not only gains, but also risks. You must keep in mind that rarely, a patient may not benefit from the surgery, and the symptoms may be worse. The risks are listed below. Hearing: This operation is designed to preserve hearing. Hearing loss after this procedure is a very rare complication. Dizziness: The primary goal of this surgery to improve dizziness in patients. If symptoms of vertigo persist after this surgery, other procedures will be considered to improve these symptoms. Infection: After any surgery, infection is a potential complication. This is very rare after this surgery. Facial Nerve Paralysis: The facial nerve controls movement on one side of the face and runs through the ear. Paralysis after this surgery is exceedingly rare, but may occur. Numbness of the Ear: It is common to have numbness of the ear after any type of ear surgery. This will improve over several months, and only very rarely is permanent. Spinal Fluid Leak: Spinal fluid bathes the brain and very rarely may leak out through the incision or through the nostrils after ear surgery. If this occurs, a procedure may need to be performed to stop the flow of fluid. Ringing: Ringing in the ear (tinnitus) is often present in patients undergoing this type of surgery. After surgery, ringing is usually less but can be worse and quite bothersome. Taste Disturbance: The nerve that supplies one third of the taste to the tongue runs through the middle ear. Therefore, temporary taste disturbance occurs rarely after this surgery. Our goal in performing endolymphatic sac surgery is to help you with the balance symptoms you are experiencing. But like other aspects of life, there are no guarantees of success. If, by chance, you have had a bad result after surgery, we will do our best to treat the problem Please let me or the staff of the Dallas Ear Institute know if you have any questions. ________________________________ _____________________________ Signature Date .

Copy Link

Recommended publications

Endolymphatic Sac Tumors: an Overview Michael B
Endolymphatic Sac Tumors: An Overview Michael B. Gluth, MD, FACS Associate Professor Director, Comprehensive Ear & Hearing Ctr. Section of Otolaryngology-Head & Neck Surgery VHL Alliance, Chicago, 2015 Disclosure • No relevant financial interests or other relevant relationships to disclose • Will discuss off-label use of cochlear implants for single-sided SNHL VHL | 2 Outline • What is an endolymphatic sac tumor? • What are the symptoms? • What is the work-up and treatment? VHL | 3 Endolymphatic Sac Anatomy VHL | 4 Endolymphatic Sac Function • Part of the “membranous labyrinth” • Filled with fluid called endolymph • Secretes locally acting chemical called “saccin” • Involved with inner ear fluid homeostasis, mechanisms not fully understood – ELS is involved with Meniere’s disease VHL | 5 ELS Tumors • Extremely rare tumor originating from the endolymphatic sac, only recognized as a unique entity since 1989 • Benign (not cancer) • Highly destructive, slowly progressive – Destroy bone of inner ear, around cranial vault/skull base, and around facial nerve – Can grow into nerves, pass through dura (sac around brain) and press on cerebellum • May be asymptomatic until inner ear is partially destroyed • Key: if hearing loss is present: high chance dura is invaded VHL | 6 Symptoms • Most common presenting symptoms: – Hearing loss (85%) – Visible mass in the ear (50%) – Ringing in the ear (48%) – Facial paralysis (44%) – Dizziness/imbalance (44%) – Headache (37%) – Other neurologic (cranial nerve) weakness (25%) • If present in both ears, outlook
[Show full text]
Morphological and Functional Changes in a New Animal Model Of
Laboratory Investigation (2013) 93, 1001–1011 & 2013 USCAP, Inc All rights reserved 0023-6837/13 Morphological and functional changes in a new animal model of Me´nie`re’s disease Naoya Egami1, Akinobu Kakigi1, Takashi Sakamoto1, Taizo Takeda2, Masamitsu Hyodo2 and Tatsuya Yamasoba1 The purpose of this study was to clarify the underlying mechanism of vertiginous attacks in Me´nie`re’s disease (MD) while obtaining insight into water homeostasis in the inner ear using a new animal model. We conducted both histopatho- logical and functional assessment of the vestibular system in the guinea-pig. In the first experiment, all animals were maintained 1 or 4 weeks after electrocauterization of the endolymphatic sac of the left ear and were given either saline or desmopressin (vasopressin type 2 receptor agonist). The temporal bones from both ears were harvested and the extent of endolymphatic hydrops was quantitatively assessed. In the second experiment, either 1 or 4 weeks after surgery, animals were assessed for balance disorders and nystagmus after the administration of saline or desmopressin. In the first experiment, the proportion of endolymphatic space in the cochlea and the saccule was significantly greater in ears that survived for 4 weeks after surgery and were given desmopressin compared with other groups. In the second experiment, all animals that underwent surgery and were given desmopressin showed spontaneous nystagmus and balance disorder, whereas all animals that had surgery but without desmopressin administration were asymptomatic. Our animal model induced severe endolymphatic hydrops in the cochlea and the saccule, and showed episodes of balance disorder along with spontaneous nystagmus.
[Show full text]
ANATOMY of EAR Basic Ear Anatomy
ANATOMY OF EAR Basic Ear Anatomy • Expected outcomes • To understand the hearing mechanism • To be able to identify the structures of the ear Development of Ear 1. Pinna develops from 1st & 2nd Branchial arch (Hillocks of His). Starts at 6 Weeks & is complete by 20 weeks. 2. E.A.M. develops from dorsal end of 1st branchial arch starting at 6-8 weeks and is complete by 28 weeks. 3. Middle Ear development —Malleus & Incus develop between 6-8 weeks from 1st & 2nd branchial arch. Branchial arches & Development of Ear Dev. contd---- • T.M at 28 weeks from all 3 germinal layers . • Foot plate of stapes develops from otic capsule b/w 6- 8 weeks. • Inner ear develops from otic capsule starting at 5 weeks & is complete by 25 weeks. • Development of external/middle/inner ear is independent of each other. Development of ear External Ear • It consists of - Pinna and External auditory meatus. Pinna • It is made up of fibro elastic cartilage covered by skin and connected to the surrounding parts by ligaments and muscles. • Various landmarks on the pinna are helix, antihelix, lobule, tragus, concha, scaphoid fossa and triangular fossa • Pinna has two surfaces i.e. medial or cranial surface and a lateral surface . • Cymba concha lies between crus helix and crus antihelix. It is an important landmark for mastoid antrum. Anatomy of external ear • Landmarks of pinna Anatomy of external ear • Bat-Ear is the most common congenital anomaly of pinna in which antihelix has not developed and excessive conchal cartilage is present. • Corrections of Pinna defects are done at 6 years of age.
[Show full text]
Endolymphatic Hydrops Meniere's
ENDOLYMPHATIC HYDROPS MENIERE’S DISEASE Introduction: Meniere’s Disease, or endolymphatic hydrops, is a disorder of the inner ear. This condition occurs because of abnormal fluctuations in the inner ear fluid called endolymph. A system of membranes, called the membranous labyrinth, contains a fluid called endolymph. This fluid bathes the inner ear balance and hearing system sensory cells and allows them to function normally. The membranes can become dilated like a balloon when pressure increases. This is called "hydrops". The amount of fluid is normally kept constant by altering the production and absorption of the fluid. Endolymph also contains a specific concentration of sodium, potassium, chloride, and other electrolytes. If the inner ear is damaged by disease, injury, or other causes, the volume and composition of the inner ear fluid can fluctuate with changes in the body’s fluid and electrolyte levels. This fluctuation in inner ear fluid can cause the symptoms of hydrops, including pressure or fullness of the affected ear, tinnitus, hearing loss, and imbalance or dizziness. Treatment of this condition is geared towards stabilizing the body fluid levels so that fluctuations in the endolymph volume can be avoided. Meniere's episodes may occur in clusters in which several attacks may occur within a short period of time. On the other hand, years may pass between episodes. Between the acute attacks, most people are free of symptoms or note mild imbalance, tinnitus, and/or hearing loss. Meniere’s affects roughly 0.2% of the population, about 200 out of 100,000 people (or in other words, 2/1000).
[Show full text]
Nomina Histologica Veterinaria, First Edition
NOMINA HISTOLOGICA VETERINARIA Submitted by the International Committee on Veterinary Histological Nomenclature (ICVHN) to the World Association of Veterinary Anatomists Published on the website of the World Association of Veterinary Anatomists www.wava-amav.org 2017 CONTENTS Introduction i Principles of term construction in N.H.V. iii Cytologia – Cytology 1 Textus epithelialis – Epithelial tissue 10 Textus connectivus – Connective tissue 13 Sanguis et Lympha – Blood and Lymph 17 Textus muscularis – Muscle tissue 19 Textus nervosus – Nerve tissue 20 Splanchnologia – Viscera 23 Systema digestorium – Digestive system 24 Systema respiratorium – Respiratory system 32 Systema urinarium – Urinary system 35 Organa genitalia masculina – Male genital system 38 Organa genitalia feminina – Female genital system 42 Systema endocrinum – Endocrine system 45 Systema cardiovasculare et lymphaticum [Angiologia] – Cardiovascular and lymphatic system 47 Systema nervosum – Nervous system 52 Receptores sensorii et Organa sensuum – Sensory receptors and Sense organs 58 Integumentum – Integument 64 INTRODUCTION The preparations leading to the publication of the present first edition of the Nomina Histologica Veterinaria has a long history spanning more than 50 years. Under the auspices of the World Association of Veterinary Anatomists (W.A.V.A.), the International Committee on Veterinary Anatomical Nomenclature (I.C.V.A.N.) appointed in Giessen, 1965, a Subcommittee on Histology and Embryology which started a working relation with the Subcommittee on Histology of the former International Anatomical Nomenclature Committee. In Mexico City, 1971, this Subcommittee presented a document entitled Nomina Histologica Veterinaria: A Working Draft as a basis for the continued work of the newly-appointed Subcommittee on Histological Nomenclature. This resulted in the editing of the Nomina Histologica Veterinaria: A Working Draft II (Toulouse, 1974), followed by preparations for publication of a Nomina Histologica Veterinaria.
[Show full text]
Ear Development Ear Development
Ear Development Ear Development The ear can be divided into three parts ◦ External Ear Auricle external auditory canal ◦ Middle Ear tympanic cavity auditory tube auditory ossicles malleus, incus, stapes ◦ Inner Ear Cochlea vestibular apparatus semicircular canals Utricle Saccule Development of Inner Ear All of inner ear derivatives arise from ectoderm Late in 3rd week ◦ otic placode (disc) appears next to hindbrain During 4th week ◦ otic placode form: otic pit otic vesicle or otocyst Young neurons delaminate from ventral otocyst Form statoacoustic (vestibulocochlear) ganglion Rhombencephalon region:formation of otic vesicles Derivatives of the 1st & 2nd branchial arches Rhombencephalon region:otic placode , otic pit and otic vesicle Development of Inner Ear epithelial structures of Otic vesicle develops to membranous labyrinth dorsomedial region elongate to form: ◦ endolymphatic appendage endolymphatic sac rest region expanded to: ◦ pars superior Utricle semicircular canals endolymphatic duct ◦ pars inferior Its ventral tip elongate and coil form cochlear duct differentiate to spiral organ of Corti Its rest gives rise to: Saccule connected to cochlea by ductus reuniens Development of the otic vesicle showing a dorsal utricular portion with endolymphatic duct, and a ventral saccular portion Saccule, cochlea & organ of Corti Outgrowth of cochlear duct-spiral fashion 8th wk.- 21/2 turns Cochlear duct conect with saccule through ductus reuniens Sensory cells of Inner Ear specialized mechanotransducers arise in six prosensory regions within developing otic vesicle ◦ In the cochlea organ of Corti ◦ In the saccule and utricle Maculae ◦ in the semicircular canals Cristae All of these sensory regions innervated by the vestibulocochlear nerve Development of the scala tympani & scala vestibuli Note:the auditory nerve and spiral ganglion Scala media - organ of Corti Hair cells Tectorial mem.
[Show full text]
The Temporal Bone
Anatomic Moment The Temporal Bone Joel D. Swartz, David L. Daniels, H. Ric Harnsberger, Katherine A. Shaffer, and Leighton Mark Despite the advent of thin-section high-reso- the inner ear structures and the external lution computed tomography and, more re- environment. cently, unique magnetic resonance imaging se- Virtually all textbooks define the inner ear as quences with thin sections, T2 weighting, and a membranous labyrinth housed within an os- maximum-intensity projection techniques, seous labyrinth. The membranous labyrinth three-dimensional neuroanatomy of the tempo- contains endolymph, a fluid rich in potassium ral bone and related structures remains some- and low in sodium, similar to intracellular fluid. what of an enigma to many medical specialists, Interposed between the membranous labyrinth neuroradiologists included. Therefore, we are and the osseous labyrinth resides a supportive undertaking a series of anatomic moments in perilymphatic labyrinth. Perilymph is similar to the hope of solidifying the most important ana- cerebrospinal fluid and other extracellular tissue tomic concepts as they relate to this region. Our fluid. approach will be organized so as to consider the The osseous labyrinth consists of the bony temporal bone to represent the complex inter- edifice for the vestibule, semicircular canals, relationship of three systems: hearing, balance, cochlea, and vestibular aqueduct. The mem- and related neuroanatomic and neurovascular branous labyrinth consists of the utricle and structures. saccule (located within the vestibule), the semi- The ear originated in fish as a water motion circular ducts, the cochlear duct, and the en- detection system (1). The vestibular (balance) dolymphatic duct. The latter is a channel within mechanism becomes more complex as we the vestibular aqueduct with communications to scale the embryologic ladder and endolymph the utricle and saccule.
[Show full text]
Mmubn000001 20756843X.Pdf
PDF hosted at the Radboud Repository of the Radboud University Nijmegen The following full text is a publisher's version. For additional information about this publication click this link. http://hdl.handle.net/2066/147581 Please be advised that this information was generated on 2021-10-07 and may be subject to change. CATION TRANSPORT AND COCHLEAR FUNCTION CATION TRANSPORT AND COCHLEAR FUNCTION PROMOTORES: Prof. Dr. S. L. BONTING EN Prof. Dr. W. F. B. BRINKMAN CATION TRANSPORT AND COCHLEAR FUNCTION PROEFSCHRIFT TER VERKRIJGING VAN DE GRAAD VAN DOCTOR IN DE WISKUNDE EN NATUURWETENSCHAPPEN AAN DE KATHOLIEKE UNIVERSITEIT TE NIJMEGEN, OP GEZAG VAN DE RECTOR MAGNIFICUS DR. G. BRENNINKMEIJER, HOOGLERAAR IN DE FACULTEIT DER SOCIALE WETENSCHAPPEN, VOLGENS BESLUIT VAN DE SENAAT IN HET OPENBAAR TE VERDEDIGEN OP VRIJDAG 19 DECEMBER 1969 DES NAMIDDAGS TE 2 UUR DOOR WILLIBRORDUS KUIJPERS GEBOREN TE KLOOSTERZANDE 1969 CENTRALE DRUKKERIJ NIJMEGEN I am greatly indebted to Dr. J. F. G. Siegers for his interest and many valuable discussions throughout the course of this investigation. The technical assistance of Miss A. C. H. Janssen, Mr. A. C. van der Vleuten and Mr. P. Spaan and co-workers was greatly appreciated. I also wish to express my gratitude to Miss. A. E. Gonsalvcs and Miss. G. Kuijpers for typing and to Mrs. M. Duncan for correcting the ma nuscript. The diagrams were prepared by Mr W. Maas and Mr. C. Reckers and the micro- photographs by Mr. A. Reijnen of the department of medical illustration. Aan mijn Ouders, l Thea, Annemarie, Katrien en Michiel. CONTENTS GENERAL INTRODUCTION ...
[Show full text]
Endolymphatic Sac Tumor Presenting As an External Ear Canal Mass: a Case Report
Case Report ISSN: 2574 -1241 DOI: 10.26717/BJSTR.2020.31.005060 Endolymphatic Sac Tumor Presenting as an External Ear Canal Mass: A Case Report Charnsiri Segsarnviriya1*, Paloch Hongtongdang1, Rutti Chumthong1 and Kantang Satayasoontorn2 1Department of Otolaryngology, Phramongkutklao Hospital, Thailand 2Department of Anatomical Pathology, Army Institute of Pathology, Thailand *Corresponding author: Charnsiri Segsarnviriya, Department of Otolaryngology, Phramongkutklao Hospital ,315 Rajvithi road, Thung Phayathai, Ratchathewi, Bangkok, Thailand ARTICLE INFO ABSTRACT Received: October 06, 2020 Background: Endolymphatic sac tumor is a rare, aggressive, locally destructive lesion of the skull base that may be sporadic or associated with von Hippel-Lindau disease. It Published: October 14, 2020 commonly presents as a bluish mass behind an intact tympanic membrane. This report describes a rare case of endolymphatic sac tumor presenting as a mass in the external ear Citation: Charnsiri Segsarnviriya, canal. Paloch Hongtongdang, Rutti Chumthong, Case: A 57-year-old female patient presented with a history of progressive unilateral Kantang Satayasoontorn. Endolymphatic hearing loss and recurrent otorrhea in the right ear for 4 months. Physical examination Sac Tumor Presenting as an External revealed a mass bulging from the posterior external ear canal. Computed tomography Ear Canal Mass: A Case Report. Biomed showed an enhancing soft-tissue density lesion in the right external ear canal with J Sci & Tech Res 31(2)-2020. BJSTR. MS.ID.005060. Abbreviations: ELST: Endolymphatic aggressiveminimal bony papillary erosion, middle including ear tumor. a fluid-filled right mastoid air cell and middle ear cavity. Sac Tumor; APMET: Aggressive Papillary Surgical removal was performed, and the final pathologic results were consistent with Discussion: Endolymphatic sac tumors originate from the endolymphatic Middle Ear Tumor; VHL: von Hippel- epithelium and are characterized by a locally aggressive papillary growth pattern Lindau; CT: Computed Tomography with bone destruction.
[Show full text]
Anatomic Moment
Anatomic Moment The Endolymphatic Duct and Sac William W. M. Lo, David L. Daniels, Donald W. Chakeres, Fred H. Linthicum, Jr, John L. Ulmer, Leighton P. Mark, and Joel D. Swartz The endolymphatic duct (ED) and the en- lies in a groove on the posteromedial surface of dolymphatic sac (ES) are the nonsensory com- the vestibule (14), while its major portion is ponents of the endolymph-filled, closed, mem- contained within the short, slightly upwardly branous labyrinth. The ED leads from the arched, horizontal segment of the VA (6, 15). utricular and saccular ducts within the vestibule After entering the VA, the sinus tapers to its through the vestibular aqueduct (VA) to the ES, intermediate segment within the horizontal seg- which extends through the distal VA out the ment of the VA, and then narrows at its isthmus external aperture of the aqueduct (Fig 1) to within the isthmus of the VA (13). The mean terminate in the epidural space of the posterior diameters of the ED, 0.16 3 0.41 mm at the cranial fossa. Thus, the ED-ES system consists internal aperture of the VA and 0.09 3 0.20 mm of components both inside and outside the otic at the isthmus, are below the resolution of capsule connected by a narrow passageway present MR imagers (Fig 6A). The correspond- through the capsule (1). In nomenclature, the ing measurements of the VA, 0.32 3 0.72 and osseous VA should be clearly distinguished 0.18 3 0.31 mm, also challenge the resolution from the membranous ED and ES, which it of current CT scanners.
[Show full text]
The Proteome of the Human Endolymphatic Sac Endolymph
www.nature.com/scientificreports OPEN The proteome of the human endolymphatic sac endolymph Christine Ölander1, Jesper Edvardsson Rasmussen1, Per Olof Eriksson1, Göran Laurell1, Helge Rask‑Andersen1 & Jonas Bergquist2* The endolymphatic sac (ES) is the third part of the inner ear, along with the cochlea and vestibular apparatus. A refned sampling technique was developed to analyse the proteomics of ES endolymph. With a tailored solid phase micro‑extraction probe, fve ES endolymph samples were collected, and six sac tissue biopsies were obtained in patients undergoing trans‑labyrinthine surgery for sporadic vestibular schwannoma. The samples were analysed using nano‑liquid chromatography‑tandem mass spectrometry (nLC‑MS/MS) to identify the total number of proteins. Pathway identifcation regarding molecular function and protein class was presented. A total of 1656 non‑redundant proteins were identifed, with 1211 proteins detected in the ES endolymph. A total of 110 proteins were unique to the ES endolymph. The results from the study both validate a strategy for in vivo and in situ human sampling during surgery and may also form a platform for further investigations to better understand the function of this intriguing part of the inner ear. Te inner ear contains two main extracellular fuid compartments, the perilymph and endolymph. Tey play essential roles in the relay of mechanic-electric transduction of sensory cells important for human hearing and balance. Te endolymphatic sac (ES) is the third part of the inner ear, along with the cochlea and vestibular apparatus, and is located in the bony canal of the vestibular aqueduct, reaching a dura mater duplicature in the posterior cranial fossa near the cerebellum.
[Show full text]
Endolymphatic Hydrops & Meniere's Disease The
ENDOLYMPHATIC HYDROPS & MENIERE’S DISEASE Endolymphatic hydrops and Meniere’s disease are disorders of the inner ear. Although the cause is unknown, it probably results from an abnormality of the fluids of the inner ear. In most cases, only one ear is involved but both ears may be affected in up to 20% of patients. THE SYMPTOMS A patient with endolymphatic hydrops may experience any combination of the below described symptoms: Vertigo is the most troublesome symptoms of endolymphatic hydrops. The vertigo of endolymphatic hydrops may occur in attacks of a spinning sensation which may result in nausea and sometimes vomiting. The vertigo may last for as short as a few minutes or as long as hours. During attacks the patient is usually unable to perform activities normal to their work and home life. Sleepiness may follow for several hours and an off-balance sensation may last for days following an attack. Some patients do not have attacks of spinning vertigo but have episodes of disequilibrium in which their head may feel as if it is swimming or the floor seems to be shifting beneath their feet. There may be an intermittent hearing loss during the disease, especially in the low pitches, but a fixed hearing loss involving tones of all pitches commonly develops in time. It is not uncommon for loud sounds to be very uncomfortable and to appear distorted in the affected ear. The excessive fluid pressure on the hearing nerves may also cause tinnitus. The tinnitus of endolymphatic hydrops may sound like crickets or a high tone but most commonly sounds like a low-pitched hiss which may increase and decrease in intensity as the fluid pressure increases and decreases.
[Show full text]