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D.T. Ginat et al.

 

 

8.22\ Labyrinthectomy

8.22.1\ Discussion

Labyrinthectomy is a treatment option for Meniere’s disease when preservation of hearing is not a consideration. The procedure can be performed via a transmastoid or transcanal approach. The transmastoid approach consists of a canal wall-up mastoidectomy removal of the semicircular canals and ablation of the vestibule

a

(Fig. 8.93). On the other hand, the transcanal approach involves simply opening the vestibule so that the vestibular neurosensory elements can be eliminated via the middle ear by elevating the tympanic membrane and resecting a portion of the scutum, as well as the stapes and incus. A defect between the round and oval windows is created (Fig. 8.94). No matter which approach is used, vestibule defects are sometimes filled with Gelfoam or other packing material.

b

Fig. 8.93  Transmastoid labyrinthectomy. Axial (a) and coronal (b) CT images show an air-filled cavity (arrows) in the expected location of the vestibule, which communicates with the mastoid bowl. The ossicles remain intact

8  Imaging of the Postoperative Ear and Temporal Bone

411

 

 

Fig. 8.94  Transcanal labyrinthectomy. Axial (a) and

a

coronal (b) CT images show a defect that extends

inferior to the oval window (arrow). There is also

 

disruption of the ossicular chain

 

b