Endolymphatic sac decompression effect on secondary symptoms of Meniere's disease

Am J Otolaryngol. 2023 Mar-Apr;44(2):103777. doi: 10.1016/j.amjoto.2022.103777. Epub 2022 Dec 26.


Objective: To evaluate if endolymphatic sac decompression (ESD) significantly improves secondary symptoms of Meniere's disease including tinnitus and aural fullness.

Study design: Survey study with retrospective chart review.

Setting: Tertiary care center.

Methods: Survey of adult patients with Meniere's disease that underwent primary ESD surgery from 2015 to 2020. Subjective reporting of pre- and postoperative aural fullness and tinnitus based on postoperative survey. Survey results and audiologic data of the patients that reported were compared pre- and postoperatively.

Results: Statistical analysis was performed using weighted kappa statistics to examine the level of agreement. There was a value of 0.12 for pre- and postoperative aural fullness, indicating a difference in the two groups with 77 % having improvement and only 4 % having worsening. There was a value of 0.21 for pre- and postoperative tinnitus, demonstrating a lack of agreement with 58 % having improvement and 4 % having worsening. Overall, there was significant improvement in both tinnitus and aural fullness postoperatively. There was no significant difference in word recognition score, speech reception threshold, or pure tone average between the pre- and postoperative group based on paired t-test.

Conclusions: There is a significant improvement in both aural fullness and tinnitus for patients undergoing ESD with no negative effect on audiologic status. ESD is a viable option for treatment of Meniere's disease with vertigo, aural fullness, and tinnitus relief. Future prospective studies are needed to further improve the evidence of ESD's effect on secondary symptoms of Meniere's disease.

Keywords: Aural fullness; Endolymphatic sac decompression; Tinnitus.

MeSH terms

  • Adult
  • Decompression
  • Endolymphatic Sac* / surgery
  • Humans
  • Meniere Disease* / diagnosis
  • Retrospective Studies
  • Tinnitus* / complications
  • Tinnitus* / surgery