Functional results after endolymphatic sac surgery in 72 patients with Menière´s disease

Objectives Meniere's disease (MD) is a disorder of the inner ear characterized by fluctuating episodes of vertigo, deafness, tinnitus, and aural fullness. A range of both ablative and non-ablative treatment options is available to MD patients. In patients unresponsive to a drug therapy with betahistine, surgery on the endolymphatic sac (ELSS) is an operative, non-ablative option. The aim of this study was to examine the pre- versus postoperative vestibular and cochlear outcome, postoperative complication rates, quality indicators and long-term prognosis of patients who received ELSS.

Design A retrospective data analysis was conducted of 72 consecutive patients with MD who underwent ELSS at one tertiary referral center between 2004 and 2019.

Results Mean age was 56.1±13.7 years with mean follow-up was 17.3±17.5 months. Postoperatively, 64.9 % (n=37) reported a reduction or absence of vertigo attacks. 18 patients received non-ablative further postoperative treatment (betahistine, re-ELSS, intratympanic application of corticosteroids), and 9 ablative treatment (intratympanic application of gentamycine, labyrinthectomy). Comparison of caloric and audiometric testing pre- to postoperative was possible in 57 patients and showed similar results. Mean pure tone audiometry according to WHO-criteria (AC-PTA4 = 0,5; 1; 2; 4 kHz) was preoperatively 63.3±1.3 vs. postoperatively 68.0±22.9. A subset of 21 patients received endolymphatic sac surgery and cochlear implantation (CI), thereof 15 ELSS and CI as a first-line surgical treatment simultaneously.

Conclusions According to the presented data, ELSS is a low-complication-rate, non-ablative therapeutic option in MD-patients unresponsive to conservative drug therapy.

Poster-PDF A-1779.PDF

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Artikel online veröffentlicht:
10. Juni 2020