Endolymphatic sac decompression with enlarged antrotomy-A modified surgery for the treatment of Ménière’s disease

Background The underlying pathophysiology of Me′nie`re’s disease is still not well defined, and the treatment of patients unresponsive to medical therapy remains controversial. In our institution, over the past years, found the mastoid and antrum in MD patient have lots of infection trace and we modified the ESD surgical technique for the treatment of Ménière’s disease: the endolymphatic sac decompression with enlarg antrotomy (ESDEA). In our opinion, Enlarged antrotomy let the mastoid drainage well and avoid the infection aggravate.

Objective to evaluate the effectiveness of ESDEA to control vertigo attacks, tinnitus, and aural fullness and to evaluate its effect on hearing level.Methods: Retrospective study in a medical center (189 patients). Surgical outcomes assessed were the presence of vertigo spells, aural fullness, tinnitus and pure tone average (PTA). Data were collected for these visits: preoperative,1 week, 1 ,6 and 24 months postoperatively.

Results: we documented 145ears have membrane tissues around the incus body (FIG.2A.2B.2C) in all 172 ears. And 21 ears have thickened mucosa (FIG.2D2E) in mastoid, 7 ears have polyps around the incus and the malleus. 48 % patients said the fell ear fullness relieved 1 week after surgery and 73 % patients did not have ear fullness felling 24 months after surgery.

Conclusions: Endolymphatic sac decompression with enlarged antrotomy is an excellent nondestructive surgical option for patients with incapacitating endolymphatic hydrops, providing a high percentage of vertigo control and hearing preservation. In our opinion, this treatment has important advantages over other forms of clinical and surgical treatment for this disease.

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Publication History

Article published online:
10 June 2020