Comparison the results of two different vestibular system surgery in patients with persistent Meniere's disease

Soheilipour, Saeed; Abtahi, Seyed Hamidreza; Soltani, Masoud; Khodadadi, Hesam-al-din

Comparison the results of two different vestibular system surgery in patients with persistent Meniere's disease

Authors

¹ Department of Otolaryngology, Isfahan University of Medical Sciences, Isfahan, Iran

² Research Center, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

Abstract

Background: Incidence rates of Meniere's disease vary considerably from 157/100,000 in the United Kingdom to 15/100,000 in the United States. Furthermore, in Iran prevalence of Meniere's disease is high, whereas we have not a reliable statistical study on it. A wide range of treatments are used for the treatment of the condition with no consensus on the most effective intervention. The aim of the present study, which involved 37 patients treated because of severe vertigo due to persistent Meniere's disease from 1996 to 2011, was to compare the effectiveness of two surgical methods cochleosacculotomy and endolymphatic sac decompression on vertigo and tinnitus.
Materials and Methods: In a cross-sectional study, we compared two surgical approaches in patients with Meniere's disease who did not respond to usual medical treatment. Twenty-three patients underwent cochleosacculotomy surgery and 14 patients endolymphatic sac decompression surgery. We compared all the patients for resolving of vertigo, tinnitus.
Results: After surgery, in patients of both group vertigo was improved significantly (P < 0.0001), tinnitus was improved, but it was not significant (P > 0.05) and hearing level was worse than before (especially in patients who had undergone cochleosacculotomy) (P < 0.0001).
Conclusion: Based on the data of the current study, cochleosacculotomy and endolymphatic sac decompression improved vertigo in patients with persistent Meniere's disease.

Keywords

References

1.	Crane BT, Schessel DA, Nedzelski J, Minor LB. Peripheral vestibular disorders. In: Flint PW, Haughey BH, Lund VJ, Niparko JK, Richardson MA, Robbins KT, et al., editors. Cummings Otolaryngology Head and Neck Surgery. 5^th ed. Philadelphia: Mosby; 2010. p. 2328-45.
2.	Wetmore SJ. Endolymphatic sac surgery for Ménière's disease: Long-term results after primary and revision surgery. Arch Otolaryngol Head Neck Surg 2008;134:1144-8.
3.	Morris BS. Meniere's disease: A common disorder in outpatient clinic. Proceedings of UCLA Healthcare 2014;18:1-3.
4.	Kitahara T, Horii A, Imai T, Ohta Y, Morihana T, Inohara H, et al. Effects of endolymphatic sac decompression surgery on vertigo and hearing in patients with bilateral Ménière's disease. Otol Neurotol 2014;35:1852-7.
5.	Derebery MJ, Fisher LM, Berliner K, Chung J, Green K. Outcomes of endolymphatic shunt surgery for Ménière's disease: Comparison with intratympanic gentamicin on vertigo control and hearing loss. Otol Neurotol 2010;31:649-55.
6.	Giddings NA, Shelton C, O'Leary MJ, Brackmann DE. Cochleosacculotomy revisited. Long-term results poorer than expected. Arch Otolaryngol Head Neck Surg 1991;117:1150-2.
7.	Convert C, Franco-Vidal V, Bebear JP, Darrouzet V. Outcome-based assessment of endolymphatic sac decompression for Ménière's disease using the Ménière's disease outcome questionnaire: A review of 90 patients. Otol Neurotol 2006;27:687-96.
8.	Hu A, Parnes LS. 10-year review of endolymphatic sac surgery for intractable meniere disease. J Otolaryngol Head Neck Surg 2010;39:415-21.
9.	Teufert KB, Doherty J. Endolymphatic sac shunt, labyrinthectomy, and vestibular nerve section in Meniere's disease. Otolaryngol Clin North Am 2010;43:1091-111.
10.	Heidenreich KD, Basura GJ, Zwolan TA, El-Kashlan HK, Telian SA. Transcanal labyrinthectomy for intractable vertigo after unilateral cochlear implantation. Otol Neurotol 2011;32:1270-2.
11.	Goto F, Tsutsumi T, Ogawa K. Lateral semicircular canal plugging with endolymphatic sac decompression as new surgical treatment for intractable Meniere's disease. Acta Otolaryngol 2012;132:893-5.
12.	Kim SH, Ko SH, Ahn SH, Hong JM, Lee WS. Significance of the development of the inner ear third window effect after endolymphatic sac surgery in Ménière disease patients. Laryngoscope 2012;122:1838-43.
13.	Berlinger NT. Meniere's disease: New concepts, new treatments. Minn Med 2011;94:33-6.
14.	Albera R, Canale A, Parandero F, Ducati A, Lanotte M. Surgical indication in Menière's disease therapy: Clinical and epidemiological aspects. Eur Arch Otorhinolaryngol 2011;268:967-72.
15.	Syed I, Aldren C. Meniere's disease: An evidence based approach to assessment and management. Int J Clin Pract 2012;66:166-70.

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