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Herbert Silverstein, MD; Warren L. Griffin, Jr., MD

Arch Otolaryngol. 1970;91(5):414-423.

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.

Author Affiliations
Boston

From the Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston.

Footnotes
Accepted for publication Jan 22, 1970.

Reprint requests to Massachusetts Eye and Ear Infirmary, 243 Charles St, Boston 02114 (Dr. Silverstein).

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