Name of the Procedure:

Labyrinthotomy with perfusion of vestibuloactive drug(s), transcanal

Summary

Labyrinthotomy with perfusion of vestibuloactive drug(s), transcanal, is a surgical procedure designed to treat certain inner ear disorders. It involves creating an opening in the bony labyrinth of the ear and infusing medication directly into the inner ear via the ear canal.

Purpose

The primary aim of this procedure is to address conditions causing severe vertigo or imbalance, such as Meniere's disease. The goal is to alleviate symptoms by delivering medication directly to the affected area, potentially reducing dizziness and improving the patient's quality of life.

Indications

• Persistent vertigo that has not responded to other treatments
• Meniere's disease
• Severe imbalance or dizziness negatively impacting daily activities
• Patients who have not achieved symptom relief through less invasive treatments

Preparation

• Patients may be advised to fast for a few hours before the procedure.
• Medications may need to be adjusted or temporarily discontinued.
• Pre-procedure diagnostic tests may include audiometry (hearing tests) and vestibular function tests.

Procedure Description

1. The patient is positioned comfortably, and local anesthesia is administered.
2. The surgeon creates a small opening in the bony labyrinth of the ear.
3. A catheter or small needle is inserted through the ear canal to access the inner ear.
4. Vestibuloactive drug(s) is carefully infused into the inner ear via the catheter.
5. The instruments are removed, and the entry site is sealed.
   • Tools used include a catheter or needle, and instruments for creating the labyrinth opening.
   • Local anesthesia is generally sufficient, though sedation may be used if necessary.

Duration

The procedure typically takes about 1 to 2 hours.

Setting

This procedure is performed in a hospital or an outpatient surgical center.

Personnel

• ENT (Ear, Nose, and Throat) surgeon
• Nursing staff
• Anesthesiologist (if sedation is used)

Risks and Complications

• Common risks: temporary dizziness, nausea
• Rare risks: hearing loss, infection, leakage of inner ear fluid, allergic reaction to medication
• Management of complications may involve medications, further surgical intervention, or follow-up care.

Benefits

• Reduction of severe vertigo and related symptoms
• Improvement in balance and quality of life
• Benefits may be realized within a few days to weeks following the procedure.

Recovery

• Post-procedure care includes resting and avoiding sudden head movements.
• Patients may need to avoid heavy lifting or strenuous activities for several days.
• Follow-up appointments are crucial to monitor progress and address any complications.
• Full recovery typically takes a few weeks.

Alternatives

• Medication management (e.g., diuretics, anti-vertigo drugs)
• Vestibular rehabilitation therapy
• Less invasive procedures like intratympanic injections
• Each alternative has its own advantages and drawbacks, and the choice depends on the patient's specific condition and overall health.

Patient Experience

• During the procedure, patients might feel some pressure or mild discomfort but should not experience significant pain due to the anesthesia.
• After the procedure, dizziness or imbalance may temporarily worsen before improving.
• Pain management strategies and comfort measures, like prescribed pain relievers and anti-nausea medication, can help manage symptoms during recovery.