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Surgical Management of Ménière’s Disease: Our Experience with Endolymphatic Sac Decompression


Authors: Richard Salzman 1;  I. Stárek 1;  V. Kamarád 2;  M. Dobiáš 3
Authors‘ workplace: Otolaryngologická klinika LF UP a FN v Olomouci 1;  Ústav histologie a embryologie LF UP v Olomouci 2;  Ústav soudního lékařství a medicínského práva LF UP a FN v Olomouci 3
Published in: Otorinolaryngol Foniatr, 62, 2016, No. 4, pp. 232-236.
Category: Original Article

Overview

Introduction:
In patients with medically intractable Ménière’s disease, surgical treatment is often considered. The aim of this paper is to describe surgical results of endolymphatic sac decompressions.

Methods:
All 6 patients who underwent endolymphatic sac decompression in the period of 2013-2016, were included in the retrospective study. After being diagnosed with intractable disease according the 1995 American Academy of Otolaryngology–Head and Neck Surgery criteria, all the patients enrolled received at least 12 month long conservative treatment with no or very little effect. Changes in following parameters were evaluated: air-bone gap, frequency and intensity of vertiginous attacks, character and intensity of tinnitus. Furthermore, patients’ satisfaction was evaluated using validated Czech translation of Glasgow Benefit Inventory and by questions: „Would you recommend your friend or relative with identical complaints like yours prior to your surgery to undergo the same surgery?“ and „Are you satisfied with the final effect of the surgery?“. Average follow-up was 11.5±4.8 months (range 5-18 months).

Results:
Vertiginous attacks completely ceased in 4 patients. Remaining 2 patients felt significant improvement and are left with 1 or 2 mild attacks in 2 year after the procedure. They all scored very high in the Glasgow Benefit Inventory. All of them would recommend the procedure to their friends or family members and expressed major satisfaction with the final result. Four patients completely discontinued the antivertiginous medication. Another patient remains on a lowered dose. The last one decided to carry on on the full dose.

Conclusion:
A patient’s statement „The surgery changed my life. After years of suffering, I returned to active and happy life.“ best describes her satisfaction with the endolymphatic sac decompression, she underwent for intractable Ménière’s disease.

Keywords:
decompression, endolymphatic sac, endolymphatic hydrops, Ménière’s disease


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Audiology Paediatric ENT ENT (Otorhinolaryngology)
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