Effects of endolymphatic sac decompression combined with posterior tympanotomy with local steroids for intractable Meniere's disease

Acta Otolaryngol. 2020 Apr;140(4):258-261. doi: 10.1080/00016489.2019.1708458. Epub 2020 Feb 7.

Abstract

Background: Endolymphatic sac decompression surgery (ESDS) is commonly used for intractable Meniere's disease, but its effect remains controversial because of the low rate of vertigo control.Objectives: In the present study, we examined ESDS combined with posterior tympanotomy with local steroids as a new therapeutic strategy for intractable Meniere's disease.Materials and methods: This retrospective study enrolled 19 patients with Meniere's disease using ESDS combined with posterior tympanotomy with local steroids between 2015 and 2018. Postoperatively we recorded and evaluated changes in vertigo attack frequency and hearing level.Results: Vertigo episodes decreased from 3.6 ± 3.2 times preoperatively to 0.2 ± 0.5 times postoperatively, with 89.5% complete vertigo control rate. Mean PTA decreased from 40.5 ± 21.3 dB to 39.5 ± 17.5 dB postoperatively, with 21.1% improvement rate.Conclusions and significance: The present findings suggest that ESDS combined with posterior tympanotomy with local steroids could improve clinical results of hearing as well as vertigo control for intractable Meniere's disease.

Keywords: Meniere’s disease; endolymphatic sac decompression; local steroids.

MeSH terms

  • Adult
  • Aged
  • Decompression, Surgical / methods*
  • Dexamethasone / administration & dosage*
  • Endolymphatic Sac / surgery*
  • Female
  • Glucocorticoids / administration & dosage*
  • Humans
  • Male
  • Meniere Disease / drug therapy
  • Meniere Disease / surgery*
  • Middle Aged
  • Retrospective Studies
  • Tympanic Membrane / surgery
  • Vertigo / drug therapy
  • Vertigo / surgery

Substances

  • Glucocorticoids
  • Dexamethasone