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Research in Vestibular Science > Volume 12(1); 2013 > Article
Research in Vestibular Science 2013;12(1): 16-21.
난치성 메니에르병에서 내림프낭감압술의 역할
김신혜, 이지혜, 유윤종, 최병윤, 구자원
서울대학교 의과대학 이비인후과학교실
Role of Endolymphatic Sac Decompression in Intractable Meniere’s Disease
Shin Hye Kim, Jihye Rhee, Yoonjong Ryu, Byung Yoon Choi, Ja Won Koo
Department of Otorhinolaryngology, Seoul National University College of Medicine, Seoul, Korea. jwkoo99@snu.ac.kr
ABSTRACT
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.
Keywords: Endolymphatic sac; Surgery; Meniere disease; Vertigo; Hearing loss
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