Endolymphatic duct blockage: a randomized controlled trial of a novel surgical technique for Ménière's disease treatment

To compare the effectiveness of the endolymphatic duct blockage (EDB) and the endolymphatic sac decompression (ESD) to control Ménière's disease symptoms and to evaluate their effect on hearing level. Prospective nonblinded randomized study. Tertiary medical center. Fifty-seven patients affecte...

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Published inOtolaryngology-head and neck surgery Vol. 152; no. 1; p. 122
Main Authors Saliba, Issam, Gabra, Nathalie, Alzahrani, Musaed, Berbiche, Djamal
Format Journal Article
LanguageEnglish
Published England 01.01.2015
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ISSN1097-6817
DOI10.1177/0194599814555840

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Abstract To compare the effectiveness of the endolymphatic duct blockage (EDB) and the endolymphatic sac decompression (ESD) to control Ménière's disease symptoms and to evaluate their effect on hearing level. Prospective nonblinded randomized study. Tertiary medical center. Fifty-seven patients affected by a refractory Ménière's disease were included out of which 22 underwent an ESD and 35 underwent an EDB. Five periods of follow-up were considered: 0 to 1 week, 1 week to 6 months, 6 to 12 months, 12 to 18 months, and 18 to 24 months. Mean outcome measurements consisted of vertigo control, tinnitus, aural fullness, instability, and hearing level. Hearing level was evaluated using pure-tone average (PTA) and speech discrimination score (SDS). There was no significant difference between the 2 groups in the number of vertigo spells per months preoperatively (P = .153). Twenty-four months postoperatively, 96.5% of the EDB group had achieved a complete control of vertigo spells against 37.5% of the ESD group with a statistically significant difference (P = .002). There was a better control of tinnitus and aural fullness with EDB (P = .021 and P = .014, respectively). There was no statistically significant difference in hearing level preoperatively (P = .976) and 24 months postoperatively (P = .287) between the 2 groups. Hearing level was preserved in each group with no significant difference between the preoperative and the postoperative levels (P > .05). EDB is more effective than the traditional ESD in controlling the symptoms of Ménière's disease. It is a novel surgical technique with promising results for a complete treatment of Ménière's disease. There are no significant complications or adverse effect.
AbstractList To compare the effectiveness of the endolymphatic duct blockage (EDB) and the endolymphatic sac decompression (ESD) to control Ménière's disease symptoms and to evaluate their effect on hearing level. Prospective nonblinded randomized study. Tertiary medical center. Fifty-seven patients affected by a refractory Ménière's disease were included out of which 22 underwent an ESD and 35 underwent an EDB. Five periods of follow-up were considered: 0 to 1 week, 1 week to 6 months, 6 to 12 months, 12 to 18 months, and 18 to 24 months. Mean outcome measurements consisted of vertigo control, tinnitus, aural fullness, instability, and hearing level. Hearing level was evaluated using pure-tone average (PTA) and speech discrimination score (SDS). There was no significant difference between the 2 groups in the number of vertigo spells per months preoperatively (P = .153). Twenty-four months postoperatively, 96.5% of the EDB group had achieved a complete control of vertigo spells against 37.5% of the ESD group with a statistically significant difference (P = .002). There was a better control of tinnitus and aural fullness with EDB (P = .021 and P = .014, respectively). There was no statistically significant difference in hearing level preoperatively (P = .976) and 24 months postoperatively (P = .287) between the 2 groups. Hearing level was preserved in each group with no significant difference between the preoperative and the postoperative levels (P > .05). EDB is more effective than the traditional ESD in controlling the symptoms of Ménière's disease. It is a novel surgical technique with promising results for a complete treatment of Ménière's disease. There are no significant complications or adverse effect.
Author Alzahrani, Musaed
Saliba, Issam
Gabra, Nathalie
Berbiche, Djamal
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  givenname: Djamal
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Keywords ear fullness
endolymphatic sac
tinnitus
vertigo
endolymphatic duct
decompression
Ménière’s disease
hearing loss
Language English
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Snippet To compare the effectiveness of the endolymphatic duct blockage (EDB) and the endolymphatic sac decompression (ESD) to control Ménière's disease symptoms and...
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StartPage 122
SubjectTerms Decompression, Surgical
Endolymphatic Duct - surgery
Female
Humans
Male
Meniere Disease - surgery
Middle Aged
Otorhinolaryngologic Surgical Procedures - methods
Prospective Studies
Title Endolymphatic duct blockage: a randomized controlled trial of a novel surgical technique for Ménière's disease treatment
URI https://www.ncbi.nlm.nih.gov/pubmed/25403881
Volume 152
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