Diagnostic Labyrinthotomy in Otologic Disorders

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Abstract
It appears that diagnostic labyrinthotomy can be a useful and worthwhile aid in certain cases of unilateral sensorineural hearing loss where acoustic neuroma or Meniere's disease is suspected. To date there have been no false-positive or negative results for either acoustic tumor (30 cases) or Meniere's disease (23 cases). Any perilymph protein concentration over 1,000 mg/100 cc is considered good evidence for acoustic neuroma. Any inner ear fluid sample collected from the vestibular cistern showing a potassium concentration of 100 mEq/liter or greater is considered good evidence for endolymphatic hydrops. Diagnostic labyrinthotomy is indicated in the following situations: (1) In cases where there is inconclusive work-up for Meniere's disease; (2) in cases where there is inconclusive work-up for acoustic neuroma; (3) routine procedure during transmeatal labyrinthectomy to confirm the diagnosis of Meniere's disease; (4) prior to stapedectomy in cases of otosclerosis, where there have been vertiginous symptoms suggestive of possible associated Meniere's disease; and (5) in cases where the patient is allergic to contrast media.

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