title: Surgical induction of endolymphatic hydrops by obliteration of the endolymphatic duct.
abstract: Surgical induction of endolymphatic hydrops (ELH) in the guinea pig by obliteration and obstruction of the endolymphatic duct is a well-accepted animal model of the condition and an important correlate for human Meniere's disease. In 1965, Robert Kimura and Harold Schuknecht first described an intradural approach for obstruction of the endolymphatic duct (Kimura 1965). Although effective, this technique, which requires penetration of the brain's protective covering, incurred an undesirable level of morbidity and mortality in the animal subjects. Consequently, Andrews and Bohmer developed an extradural approach, which predictably produces fewer of the complications associated with central nervous system (CNS) penetration.(Andrews and Bohmer 1989) The extradural approach described here first requires a midline incision in the region of the occiput to expose the underlying muscular layer. We operate only on the right side. After appropriate retraction of the overlying tissue, a horizontal incision is made into the musculature of the right occiput to expose the right temporo-occipital suture line. The bone immediately inferio-lateral the suture line (Fig 1) is then drilled with an otologic drill until the sigmoid sinus becomes visible. Medial retraction of the sigmoid sinus reveals the operculum of the endolymphatic duct, which houses the endolymphatic sac. Drilling medial to the operculum into the area of the endolymphatic sac reveals the endolymphatic duct, which is then packed with bone wax to produce obstruction and ultimately ELH. In the following weeks, the animal will demonstrate the progressive, fluctuating hearing loss and histologic evidence of ELH.
authors.affiliation: Otolaryngology - Head and Neck Surgery, Case Western Reserve University, USA. cliff.megerian@uhhospitals.org
authors.forename: Cliff A
authors.initials: CA
authors.lastname: Megerian
authors.forename: Chris
authors.initials: C
authors.lastname: Heddon
authors.forename: Sami
authors.initials: S
authors.lastname: Melki
authors.forename: Suhael
authors.initials: S
authors.lastname: Momin
authors.forename: Janis
authors.initials: J
authors.lastname: Paulsey
authors.forename: Joy
authors.initials: J
authors.lastname: Obokhare
authors.forename: Kumar
authors.initials: K
authors.lastname: Alagramam
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D004711:Endolymphatic Duct / Q000601:surgery*; D018159:Endolymphatic Hydrops / Q000209:etiology*; D006168:Guinea Pigs; D006801:Humans; D008575:Meniere Disease