Objective:To describe a novel approach for intractable Meniere's disease exclusively through a transcanal endoscopic ear surgery（TEES）. Methods:This retrospective chart review included patients with intractable Menière's disease who underwent endoscopic transcanal labyrinthectomy in the Department of Otolaryngology Head and Neck Surgery, Guangxi Hospital Division, First Affiliated Hospital, Sun Yat-sen University, between February 2023 and October 2024. The first 70-year-old woman and the other 67-year-old woman, who underwent multiple conservative treatment and chemical labyrinthectomy during outpatient and hospitalization, had frequent vertigo, tinnitus and severe sensorineural deafness. The TEES approach provided a wide exposure of the oval window. The incus and the stapes were removed, expanded the oval window. The perilymph was suctioned, The saccule, utricule, macula utriculi and macula sacculi were removed. The ampulla tissue of the three semicircular canal were destroyed with the right-angle crochet. The oval window was obliterated using the perichondrium of the tragal cartilage and cartilage. Results:Two patients underwent endoscopic transcanal labyrinthectomy, and no intraoperative or postoperative complications were observed. Vertigo was controlled in 2 patients during the follow-up of 6 to 12 months. Two patients complained of total hearing loss after surgery. Conclusion:Even though this study presents a limited number of cases, endoscopic transcanal labyrinthectomy is a promising, safe, and effective procedure in selected cases. Additional studies are needed to determine the risk-benefit profile of this technique.
Humans ; Aged ; Female ; Meniere Disease/surgery* ; Retrospective Studies ; Endoscopy/methods* ; Otologic Surgical Procedures/methods* ; Ear, Inner/surgery* ; Treatment Outcome

Objective:To study the effects of Ginkgo Biloba extract (GBE)on the differentiation and bone resorption of the osteoclasts,and to clarify their mechanisms.Methods:The RAW264.7 cells were cultured in vitro,then were treated with receptor activator for nuclear factor-κB ligand (RANKL)and different concentrations of GBE. The cells were divided into blank control group (0 μg · L -1 RANKL ), RANKL group (100 μg·L -1 RANKL),RANKL + 75 mg · L -1 GBE group, and RANKL + 150 mg · L -1 GBE group.The morphology and number of osteoclasts were assessed with TRAP staining assay,and bone resorption of GBE was examined with bone resorption pits assay. Flow cytometry was applied to analyze the the apoptotic rate of RAW264.7 cells and the cell cycle; the expression levels of nuclear factor of activated T cells 1 (NFATc1 ), DC-STAMP,Casthepin K,matrix metalloprotein 9 (MMP-9),Bcl-2,Bax,P27 and Cyclin-D1 in the RAW264.7 cells were analyzed by RT-PCR method.Results:Compared with blank control group,the number of osteoclasts in RANKL group were significantly increased (P <0.01);compared with RANKL group,the number of osteoclasts in RANKL+75 mg·L -1 GBE and RANKL+150 mg·L -1 GBE groups were significantly decreased (P <0.05). Compared with blank control group,the area of bone resorption pit of bone slice in RANKL group was significantly increased (P <0.05);compared with RANKL group,the areas of bone resorption pit of bone slice in RANKL+75 mg·L -1 GBE and RANK+150 mg·L -1 GBE groups were significantly decreased (P <0.05).Compared with blank control group,the apoptotic rates of the RAW264.7 cells in 75 and 150 mg · L -1 GBE groups were increased,and the expression levels of Bcl-2 in the RAW264.7 cells were significantly decreased and the expression levels of Bax were significantly increased (P <0.05).Compared with RANKL group,the G0-G1 phase arrest of the RAW264.7 cells in RANKL+ 75 mg· L -1 GBE and RANKL 150 mg· L -1 GBE groups were shortened;the expression levels of P27 in the RAW264.7 cells were significantly decreased and the expression levels of Cyclin-D1 were significantly increased (P < 0.05).Compared with blank control group,the expression levels of NFATc1, DC-STAMP,Casthepin K and MMP-9 in the RAW264.7 cells in RANKL group were significantly increased (P <0.05);compared with RANKL group,the expression levels of NFATc1,DC-STAMP,Casthepin K and MMP-9 in the RAW264.7 cells in RANKL+75 mg·L -1 GBE and RANKL+ 150 mg·L -1 GBE groups were significantly decreased (P <0.05).Conclusion:GBE could inhibit the differentiation and bone resorption of the osteoclasts,and their mechanisms may be related to promoting the apoptosis of RAW264.7 and shortening the G0-G1 phase of the RAW264.7 cells.