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Original Article
- Clinical Outcomes of Endolymphatic Sac Decompression Surgery in Menière’s Disease
- Hee Won Seo, Young Sang Cho, Won-Ho Chung
- Res Vestib Sci. 2023;22(4):97-105. Published online December 15, 2023
- DOI: https://doi.org/10.21790/rvs.2023.22.4.97
- 1,684 View
- 65 Download
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Abstract
PDF - Objectives
Endolymphatic sac decompression surgery (ESDS) is one of the surgical methods for intractable Menière’s disease (MD), and it is known as a relatively safe treatment that does not cause hearing loss. However, the effectiveness and the degree of vertigo control rate of ESDS are still controversial. In this study, we aimed to evaluate the clinical outcomes of ESDS in intractable MD.
Methods
We retrospectively reviewed 33 patients who underwent ESDS for intractable MD from January 2002 to March 2022. Clinical characteristics of patients, pure tone threshold, medical treatment method, and number of vertigo attacks before and after surgery were assessed. The improvement of hearing and vertigo was evaluated according to the 1995 American Academy of Otolaryngology-Head and Neck Surgery criteria.
Results
Of the 33 patients, the average follow-up period was 21.2 months, with immediate follow-up within 2 months (28 patients), short term between 2 and 6 months (27 patients), and long term at 12 months or later (29 patients). In the immediate hearing threshold, both air conduction and bone conduction showed slight deterioration, but there was no significant change in the long-term hearing threshold. At long-term follow-up, 12 patients (41.4%) were able to live without medication, and 18 patients (62.1%) showed improvement in their vertigo symptoms. In addition, patients who showed improvement in hearing also showed improvement in vertigo at the same time.
Conclusions
ESDS in intractable MD is a relatively safe and effective treatment method for reducing vertigo attack without worsening hearing threshold.
Case Reports
- Tumarkin Otolithic Crisis Controlled by Endolymphatic Sac Surgery
- Seok Min Hong, Il Seok Park, Jae Ho Ban
- Res Vestib Sci. 2015;14(1):32-35.
- 2,451 View
- 53 Download
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Abstract
PDF
- Turmarkin otolithic crisis is a rare feature of Meniere’s disease. It shows sudden falling to the ground with no warning sign. It is an otologic emergency because of the risk of falling, and it has traditionally been treated with labyrinthectomy or vestibular neurectomy. We experienced a 49-year-old male suffering from recurrent drop attack, and found that he had hearing loss, tinnitus or recurrent vertigo on his left ear, and could make a diagnosis him as Tumarkin otolithic crisis. We have performed the endolymphatic sac decompression, considering the hearing preservation and therapeutic opinion of patients. Two years after surgery, he showed intermittent, mild dizzy symptoms, without further drop attack. Therefore, we report our clinical experience with a brief review of literature.
- Profound Hearing Loss after Endolymphatic Sac Decompression in Intractable Meniere’s Disease
- Pona Park, Kyung Tae Park, Hyun Seok Choi, Ja Won Koo
- Res Vestib Sci. 2014;13(3):72-76.
- 2,112 View
- 38 Download
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Abstract
PDF
- Endolymphatic sac decompression (ESD) is indicated in intractable Meniere’s disease patients with serviceable hearing. A 43-year-old man presented with recurrent vertigo and fluctuating right hearing loss that had been intractable to medical treatment. ESD was performed for the purpose of vertigo control with hearing preservation. Positional vertigo with profound hearing loss developed immediate after surgery and positional vertigo was resolved within days. Following paralytic vestibulopathy with positive sign on head thrust test also resolved after 2 weeks, while sensorineural hearing loss was not recovered to preoperative level during 1 year of follow up. Recurrent vertigo attacks were developed again 1 year after the operation. Hearing preservation was not always guaranteed in ESD. Furthermore, chance of hearing loss should be included in informed consent though the procedure is purposed for hearing preservation.
Original Article
- Role of Endolymphatic Sac Decompression in Intractable Meniere’s Disease
- Shin Hye Kim, Jihye Rhee, Yoonjong Ryu, Byung Yoon Choi, Ja Won Koo
- Res Vestib Sci. 2013;12(1):16-21.
- 2,148 View
- 20 Download
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Abstract
PDF
- Background and Objectives: The role of endolymphatic sac decompression (ELSD) for the treatment of intractable Meniere disease (MD) has been debated. However, considering few treatment options for medically intractable MD with serviceable hearing or intractable bilateral MD, ELSD has shown reasonable treatment results without ablating inner ear function. The aims of this study are to review the role of ELSD in the treatment of MD and clinical course and long-term outcome after ELSD. Materials and Methods: The ELSD was performed in 7 patients among 603 definite Meniere disease patients between May 2003 and December 2010. Patient’s medical history and clinical courses after surgery were obtained by medical record review and telephone interview. Results: Mean duration of follow up until receiving ELSD was 575 days since initial visit. Six patients showed complete control or substantial control of vertigo, but one patient suffered from sustained vertigo attacks even after ELSD, the vertigo was controlled after intratympanic gentamicin injection (ITGI) at 20 months after ELSD. Another patient had recurrence of vertigo after 30 months, which was successfully controlled by ITGI. The preoperatively mean monthly vertigo was 4.8 and it was significantly decreased to 1.5 after postoperatively 1 year, 0 after postoperatively 2 years (p<0.001). Hearing was preserved in 6 patients during the follow-up period. Conclusion: Most patients who were uncontrolled vertigo with 3 to 6 months medication showed significantly reduced vertigo and hearing preservation after ELSD. The ELSD seems to be a beneficial treatment option for intractable MD.
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