Which statement by a client diagnosed with Ménière’s disease who has had a labyrinthectomy of the left ear indicates that he understands the discharge teaching concerning the surgery?
A. "I should be able to hear fairly well after the edema in my ear subsides."
B. "I will be totally deaf in my left ear, but the dizziness will be gone."
C. "I should remove the inner ear packing in exactly 3 days."
D. "I should lubricate the skin around my stoma with petroleum jelly."
Correct Answer: B. “I will be totally deaf in my left ear, but the dizziness will be gone.”
A labyrinthectomy is the most radical procedure for Ménière’s disease. It involves resection of the vestibular nerve or total removal of the labyrinth by the transcanal route. Although this procedure controls the disorder, it results in deafness in the affected ear. Because labyrinthectomy necessarily causes total hearing loss in the operated ear, one of the primary contraindications for this procedure is serviceable hearing in the diseased ear.
Option A: This procedure surgically removes the neuroepithelial elements of the semicircular canals and vestibule. Its goal is to ablate abnormal signals from a diseased vestibular system in order to facilitate central compensation, and it is generally very successful. The procedure does result in loss of all remaining hearing in the operated ear.
Option C: With this procedure, inner ear packing is not used. Once the procedure has been completed, the middle ear is packed with gel foam soaked in gentamicin to chemically ablate any remaining neuroepithelium that may have been missed.
Option D: With this procedure, a stoma is not created. The goal of the labyrinthectomy procedure is to ablate an unstable and dysfunctional vestibular system in order to promote central compensation for patients with episodic vertigo and/or baseline disequilibrium. As discussed earlier, total hearing loss in the operated ear is expected.
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