Labyrinthectomy surgery

Please let us know how you are getting on. Best of luck !

 

Dhors, I urge you to take the above comment by Scott Tom very seriously.

As we've PM'd about, you and I have similar recent histories (though yours is much worse). I don't know if a laby will fix your symptoms if you have MAV. You must find this out. If not, I implore you to hold off the laby and explore your possible MAV or virus condition.

From the dark place I'm in right now, if I could I'd tie you to your kitchen table and not let you have surgery until you figured all this out.

 

Wouldn’t MRI with contrast determine it’s s MM? My doctor was able to see hydro drops in the image and then he decided I could go ahead the surgery. If it’s so simple (not entirely sure) why would not doctors refer their patients to have one done?

 

Because it doesn't work that way. You cannot determine that it's MM. You can only rule out other possibilities and then diagnose MM by elimination. The problem is that the most doctors won't do all the tests and it's easier for them to just call it MM and prescribe X, Y and Z. It's especially easy for them to prescribe surgery, since they get paid the big bucks for that.

 

Btw, my last post is not mean to diss the laby. It obviously works for people who really do have MM. I'm only commenting on the general practice of doctors to make snap decisions without all the facts/tests/etc.

 

Scott I appreciate your last post. I can remember a post a few years back where I made a similar statement regarding the people on this forum who have MAV and not MM or think they have MM because they have some of the symptoms that are associated with MM. I wonder today how many on this board have the correct diagnosis. Same with drop attacks how many have had a real drop attack? I have a hard time believing that anyone would choose to live knowing that a drop attack could cause permanent and or life threatening damage. The first ENT I saw was a horses ass. He did diagnose me with MM but because he told me to live with it I searched out an OTO. Best move I made. My OTO worked with me for over a year until the drop attack and then he highly recommended the laby. So you are correct most important part of making a decision on having surgery is making sure you have the correct diagnosis and the best OTO you can find.

 

Redwing, how many drop attacks did you have before your labby? I have had 2 in 21 months apart. Both times I have sustained injury, the most recent one causing the broken neck.

 

I would also be curious to know how many members have had a true drop attack?

 

You mean where you instantly meet the floor with no warning and puking your guts up for the next few hours? Yeah... been there. Sucks.

 

My drop attacks do not involve vertigo, I have no spinning. It is like someone hit me over the head and temporarily knocked out and I fall like a puppet having it’s strings cut.

I do have severe vertigo atta is with no warnings, but that it much different than a drop attack for me.

 

I had 3 drop attacks within a 3 month period. The one that changed my life happened when I was out for a walk. I was chatting with my husband as we were walking the next thing I knew I was in the ground spitting dirt out of my mouth and wondering who came up from behind me and hit me in the back of the head with a baseball bat! My poor husband was scared to death. I tore my rotator cuff and had a cut over my eye. After the attack I felt fine in terms of no puking and no vertigo. All I could think of was what if I had been driving with my grandkids in the car?? That was enough for me to call it quits and have a laby. For the record I had very little hearing in my MM ear and tried gent shot before I made my decision. I was dizzy 24 hours a day so I really was ready.

 

Mine came together. It's completely out of the blue, and i'm on the floor spinning.

 

My challenge is I still have good hearing in my affected ear, and besides the tinnitus and vertigo attacks that last at most 10 seconds, I generally feel ok. I have no brain fog or dizziness, that all stopped 6 months ago. If I had constant dizziness I would be more apt to want the labby. As I mentioned in another post, I see my surgeon on Dec, 13, and doubt he would even consider the labby.

 

My God. We're living in a madhouse.

 

I've had something where completely out of the blue the world feels like it suddenly rotates 90 or more degrees. I grab onto whatever's nearest to me and hold on for dear life or fall to my knees and then hug the floor. After a few seconds I continue to be spinning, but much slower. My oto does not think these are drop attacks, and they don't quite sound like what the rest of you describe. She thinks these are MAV. (She has diagnosed me with both MM and MAV.) The strange thing is that since I've been on the AVs, these have only happened when I am at less than full dose, which suggests they are related to the virus. Perhaps this speaks to the connection between MM and MAV. I don't know, it's confusing.

 

From Cleveland Clinic article on Vestibular Neuritis. No author listed.

Written by someone who's obviously never spun. Imagine talking to a friend and saying, "Yeah, no biggy, I only had severe vertigo for a couple of days."

Stick to heart surgery Cleveland.

 

Can someone explain the basic difference between a Laby and VNS? Like you are talking to a 4th grader pls LOL..

 

Regarding drop attacks, i have no personal experience but here is a description. There are many articles out there but i tried to get one that was from a reasonably authoritative source.

Diagnosis and management of drop attacks of vestibular origin: Tumarkin's otolithic crisis.

Black FO, Effron MZ, Burns DS.
Abstract
Erroneous signals of vestibular origin can cause sudden falls without warning. Drop attacks of vestibular origin in our experience most commonly occurred in patients with late or end-stage endolymphatic hydrops (usually idiopathic, ie, Meniere's disease). Eponymically termed Tumarkin's otolithic crisis, drop attacks of vestibular origin must be distinguished from drop attacks due to cardiovascular abnormalities, seizure disorders, vertebral basilar arterial insufficiency (transitory brain stem ischemia), multiple sclerosis, and drug-induced motor control disturbances. The treatment of choice for drop attacks of vestibular origin is either surgical ablation (labyrinthectomy) in the absence of serviceable hearing or middle fossa vestibular nerve section in order to preserve serviceable hearing.
PMID: 6810273 DOI: 10.1177/019459988209000221
[Indexed for MEDLINE]
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https://www.ncbi.nlm.nih.gov/pubmed/6810273

 

I can give you the fourth grade version which is about my level. The 8th cranial nerve is in two parts. One part carries balance info to the brain. The other part carries hearing info. All the inner ear parts as sell as these nerves are very small and in a very compact hard-to-get-to space. This nerve starts at the inner ear and goes to the brain.

A VNS cuts the balance part of the 8th nerve but leaves the hearing part in tact. This is a tricky surgery which is technically a brain surgery since you are cutting a wire connected to the brain. Sometimes it is necessary to move the brain a bit to get at things. The plus of a vns is it preserves hearing inthe affected ear while disconnecting the balance part. The down side is it is very complicated and risks many side effects like a spinal fluid leak, perhaps touching another nerve close by and that kind of thing. It is performed i believe by a team including a neurosurgeon.

A labyrinthectomy destroys the balance potion of the inner ear but in the process also sacrifices the hearing in that ear. It is a much simpler procedure i think because access is easier and does not involve the brain but the hearing is lost.

I believe both these surgeries have various 'approaches' that can be used. If i were looking at either one, among the questions i would ask the surgeon is 'will it be possible for me to have a cochelar implant in this ear in the future if need be? The answer may be different depending who is doing the surgery and how.

I have had surgery similar to a vns but not a laby. Perhaps someone who has had a laby can chine in here. Either way, you are going to lose your balance mechism and a period of rehab will be necessary to relearn walking etc.