Labyrinth Anesthesia – A Forgotten but Practical Treatment Option in Ménière’s Disease

Abstract

The aim of this study was to determine the efficiency of labyrinth anesthesia – the intratympanic instillation of lidocaine – in the treatment of Ménière’s disease and to recall a forgotten method. Twenty-four patients (15 male, 9 female), aged from 19.7 to 80.6 years (mean: 47.8 years) with the clinical diagnosis of unilateral Ménière’s disease who underwent labyrinth anesthesia in our department were included in this retrospective study. After local anesthesia of the tympanic membrane, a solution of 4% lidocaine and furfuryladenine (Kinetin) was instilled into the tympanic cavity. Patient records, a questionnaire and a physical examination were used to evaluate vertigo control, hearing loss, tinnitus, and quality of life according to the AAO-HNS criteria before and after surgery. Postoperatively, 87.5% of patients reported at least a noticeable decrease of vestibular symptoms, 66.7% of these patients were free of attacks for an average of 26.5 months. Postoperative hearing was the same or even improved in 87.5% of our patients. Tinnitus was not affected in any individual. Based on the findings presented herein, we consider labyrinth anesthesia a practicable and, due to its safety, highly recommendable therapeutic option for patients suffering from Ménière’s disease.

Kinetin—A multiactive molecule

“…The topical treatment with kinetin normalized hyperpigmentation, improved the aged skin structure of hairless dogs, at the same time, had no adverse effects on the skin of hairless dogs, and showed that this agent was a safe chemical for long-term application [72].…”

Neuropharmacology of Vestibular System Disorders

“…Transtympanic instillation of a solution of 4% lidocaine with furfuryladenine produced a remarkable improvement in the vestibular symptoms in 87.5% of patients; 67% of these patients were free of attacks after approximately 26 months of follow up. In this work, as in the previously cited studies, lidocaine was coapplied with other drugs, in this case N(6)-furfuryladenine, which is a natural stable secondary DNA damage product with very well defined cytokine and anti-aging properties that has been linked to oxidative processes in cells [2, 12]. …”

Tenotomy of the middle ear muscles causes a dramatic reduction in vertigo attacks and improves audiological function in definite Meniere's disease

“…Analogous to Adunka et al [16], we opted not to include a control group because this study did not aim to prove one surgical technique superior to another, but solely to show the immediate and prolonged effects of tenotomy. We also do not deem it ethically sound to leave patients in need of invasive therapy untreated, so as to create a placebo control group.…”