The injections are performed with the patient lying down and using the office microscope. The ear is first cleaned of wax. A small area of the eardrum is numbed with a drop of medication. A small needle and syringe are then used and the needle is passed through the eardrum at the site that is numbed so that the tip is in the ear, near the round window. This is a membrane where drugs are absorbed in to the cochlea. The fluid is injected in to the middle ear and the patient stays lying down for 20-30 minutes during which he does not swallow or sniff. The drug sits against the round window and is absorbed in to the inner ear. The patient then sits up slowly and leaves the office. Patients should not drive for a few hours after this procedure. Water is kept out of the ear until it is confirmed that the tiny hole has healed.
superior semicircular canal dehiscence / superior canal dehiscence syndrome - known as Minor syndrome, superior canal dehiscence is a middle fossa skull base defect involving one of the vestibular (balance) organs. Specifically, a tiny hole in the superior (also known as anterior semicircular canal) in one or both ears can cause hearing loss AND/OR imbalance / dizziness, fullness of the involved ear and autophony (echo during self-vocalization). Superior semicircular canal dehiscence (SSCD) or superior canal dehiscence syndrome (SCDS) can result in many symptoms that resemble more common disorders of hearing loss and imbalance like otosclerosis, Eustachian tube dysfunction, patulous Eustachian tube, Menieres disease or BPPV.
This is a very important and much underestimated aspect in the management of Menieres disease. This can help minimize stressors which act as a trigger to acute attacks, and can also help in the management of underlying tinnitus, dizziness and imbalance. A syndrome labeled psychophysiologic dizziness plays a large role in many patients with Meniere’s Disease. This essentially where an insult to the vestibular system leaves a degree of nerve damage. The brain needs to compensate for this loss and anxiety, especially anxiety centred on the fear of further attacks or dizziness can further amplify the symptoms of instability.