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Erschienen in: HNO 9/2013

01.09.2013 | Leitthema

Indikation und Erfolge der operativen Therapie des vestibulären Schwindels

verfasst von: Univ.-Prof. Dr. M. Westhofen

Erschienen in: HNO | Ausgabe 9/2013

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Zusammenfassung

Operationen gegen Labyrinthschwindel mit schwerer Beeinträchtigung ohne Ansprechen auf Medikamente werden uneinheitlich indiziert. Therapieergebnisse sind wegen unterschiedlicher Ziel- und Erfolgsparameter nur bedingt vergleichbar. Eine Übersicht über Schrifttum und eigenes Vorgehen gibt Hinweise für Indikation und Gefahren in der operativen Therapie vestibulären Schwindels. Ergebnisse funktionserhaltender und ablativer Therapie werden vergleichend bewertet. Eine Operationsindikation bei Menière-Syndrom (nichtidiopathisch) durch Paukenröhrchen besteht bei mittelohrvermittelter Druckeinwirkung, bei M. Menière (idiopathisch) für Frühformen mit erhaltener Hör- und Labyrinthfunktion durch die endolymphatische Shunt-Operation, bei deren Versagen durch Vestibularisneurektomie zum Hörerhalt und durch Cochleosacculotomie bei erloschenem Hörvermögen. Seltene Indikationen ergeben sich bei therapieresistentem benignem paroxysmalem Lagerungsschwindel und Dehiszenz des superioren Bogengangs. Erfolge der funktionserhaltenden Verfahren bei Menière-Syndrom und M. Menière liegen zwischen 70 und 88 %, der ausschaltenden Verfahren bei > 90 %, bei Bogengangsokklusionen von > 95 %.
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Metadaten
Titel
Indikation und Erfolge der operativen Therapie des vestibulären Schwindels
verfasst von
Univ.-Prof. Dr. M. Westhofen
Publikationsdatum
01.09.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
HNO / Ausgabe 9/2013
Print ISSN: 0017-6192
Elektronische ISSN: 1433-0458
DOI
https://doi.org/10.1007/s00106-013-2749-5

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