Effects of Endolymphatic Sac Decompression Surgery on Vertigo and Hearing in Patients With Bilateral Ménière’s Disease

Kitahara, Tadashi; Horii, Arata; Imai, Toshio; Ohta, Yumi; Morihana, Tetsuo; Inohara, Hidenori; Sakagami, Masafumi

doi:10.1097/mao.0000000000000469

Cited by 7 publications

(5 citation statements)

References 24 publications

(17 reference statements)

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“…Although both migraine and Meniere's disease have a female predominance, migraine has a greater association with females as seen in large-scale epidemiological studies [1,19]. Prior studies on ESS do not consistently demonstrate a female predominance in their surgical candidates [7,9,23,24].…”

Section: Discussionmentioning

confidence: 94%

Outcomes of Endolymphatic Sac Surgery for Meniere’s Disease with and without Comorbid Migraine

Orabi

Kellermeyer

Roberts

et al. 2021

International Journal of Otolaryngology

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Purpose. To explore outcomes of endolymphatic sac surgery for patients with Meniere’s disease with and without the comorbid condition of migraine. Materials and Methods. A retrospective chart review of adult patients undergoing endolymphatic sac surgery at a single tertiary care center from 1987 to 2019 was performed. All adult patients who failed medical therapy and underwent primary endolymphatic sac surgery were included. The main outcome measures were vertigo control and functional level scale (FLS) score. Patient characteristics, comorbidities, and audiometric outcomes were tracked as well. Results. Patients with Meniere’s disease and migraine had a stronger association with psychiatric comorbidities (64.29% vs. 25.80%, p = 0.01 ), shorter duration of vertigo episodes (143 vs. 393 min, p = 0.02 ), and younger age (36.6 vs. 50.8 yr, p = 0.005 ) at the time of endolymphatic sac surgery. Postoperative pure tone averages and word recognition scores were nearly identical to preoperative baselines. Class A vertigo control (47.92%) was most common, followed by class B vertigo control (31.25%). The FLS score improved from 4.2 to 2.8 ( p < 0.001 ). Both patients with and without migraine had classes A-B vertigo control (66.67% vs. 80.95%) without any statistically significant difference ( p = 0.59 ). Of the patients who required secondary treatment (10.42%), none had migraine. Conclusions. Endolymphatic sac surgery is an effective surgical intervention for Meniere’s disease with and without migraine. Patients with comorbid migraine tend to be younger and present with psychiatric comorbidities.

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Section: Discussionmentioning

confidence: 94%

Outcomes of Endolymphatic Sac Surgery for Meniere’s Disease with and without Comorbid Migraine

Orabi

Kellermeyer

Roberts

et al. 2021

International Journal of Otolaryngology

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“…Studies in the literature report varying rates of vertigo control with different surgical techniques (Liu, 86% [1] ; Thomsen, 53% [8] ; Welling, 67% [9] ; Telischi, 81% [13] ; Brinson, 67% [14] ; Fukushima,78% [15] ; Kitahara, 90% [16] ; and Durland, 37% [17] ). The success of surgical interventions may be time sensitive, particularly in the early phases of the disease, and may prove more useful in the fluctuating hearing phase than later in the natural course of MD [18] .…”

Section: Discussionmentioning

confidence: 99%

Endolymphatic Duct Blockage for Refractory Ménière’s Disease: Assessment of Endolymphatic Sac Biopsy on Short-Term Surgical Outcomes

Asmar¹,

Saliba²

2016

Int Adv Otol

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OBJECTIVE:Endolymphatic sac decompression (ESD) for the treatment of Ménière's disease (MD) has had limited success and variable results in the literature. We have devised a novel technique that involves blocking the endolymphatic duct with surgical clips. In a separate effort to study the endolymphatic sac (ELS), we have sectioned the lateral part of the main body of the ELS as biopsies from a subset of patients. We aimed to evaluate the effect of the lateral part sectioning of the ELS on short-term surgical outcomes. MATERIALS and METHODS:This was a single-physician, retrospective study in a tertiary medical center. MD patients underwent endolymphatic duct blockage (EDB) surgery with or without ELS biopsy. The assessed surgical outcomes were the occurrence of benign paroxysmal positional vertigo (BPPV), intraoperative CSF leaks, aural fullness, tinnitus, vertigo spells, and pure tone audiometry. Data were collected at the following visits: preoperatively 1 st week, 1 st month, and 6 th months. RESULTS:A total of 63 patients were included. The outcomes of the biopsy group (EDB+B) (n=27) were compared to those of the EDB group (n=36) at each visit. There was no significant difference in the occurrence of postoperative BPPV, CSF leaks, aural fullness, tinnitus, or vertigo spells. The SDS, the PTA, and bone conduction were not significantly different at any visit, and PTA variations were similar in both groups. CONCLUSION:Our results suggest that aggressive decompression of the ELS by sectioning the sac does not benefit patients in the early postoperative period. The short-term success of EDB surgery is attributable to the effective obstruction of the endolymphatic duct regardless of pressure in the ELS.

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“…Decompression of the endolymphatic sac involves reducing pressure in this space. It is considered a conservative procedure because of the low rate of hearing loss and the high success rate (around 80% or more) of vertigo control [7,8].…”

Section: Endolymphatic Sac Decompression and Shunt In The Endolymphatmentioning

confidence: 99%

Surgical Procedures for Ménière’s Disease

Bento¹,

Lopes²

2019

Meniere's Disease [Working Title]

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The aim of this chapter is to present a literature review on some of the main articles describing different interventions for the treatment in patients with progressive intractable Ménière disease symptoms. Even though each paper presents good results in defending its techniques, there have been few well-designed clinical studies, that is, studies involving control groups or long-term observation, in the efficacy of surgery with respect to vertigo control and hearing preservation. Focusing on presenting the different techniques established in the literature, we discuss the main indications and results obtained regarding the control of vertigo and the audiological outcomes after the procedure. Physicians should offer additional treatment strategies for Meniere's disease patients with a long history of limiting symptoms or associated hearing loss. The surgical options for such patients should be considered carefully because surgery can damage the ipsilateral ear and the hearing function of the contralateral ear is often suboptimal. Its importance is that alternatives for treatment can only be offered to a patient when doctor knows them.

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Effects of Endolymphatic Sac Decompression Surgery on Vertigo and Hearing in Patients With Bilateral Ménière’s Disease

Abstract: The present findings suggest that ESDS combined with local corticosteroid treatment can control progressive hearing loss in both ears in patients with bilateral MD at least during the first 2 postoperative years.

Cited by 7 publications

References 24 publications

Outcomes of Endolymphatic Sac Surgery for Meniere’s Disease with and without Comorbid Migraine

Outcomes of Endolymphatic Sac Surgery for Meniere’s Disease with and without Comorbid Migraine

Endolymphatic Duct Blockage for Refractory Ménière’s Disease: Assessment of Endolymphatic Sac Biopsy on Short-Term Surgical Outcomes

Surgical Procedures for Ménière’s Disease

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