Res Vestib Sci.  2023 Dec;22(4):97-105. 10.21790/rvs.2023.22.4.97.

Clinical Outcomes of Endolymphatic Sac Decompression Surgery in Menière’s Disease

• Seo HW
• Cho YS
• Chung WH

• KMID: 2549103
• DOI: http://doi.org/10.21790/rvs.2023.22.4.97

Abstract

Objectives
Endolymphatic sac decompression surgery (ESDS) is one of the surgical methods for intractable Menière’s disease (MD), and it is known as a relatively safe treatment that does not cause hearing loss. However, the effectiveness and the degree of vertigo control rate of ESDS are still controversial. In this study, we aimed to evaluate the clinical outcomes of ESDS in intractable MD.
Methods
We retrospectively reviewed 33 patients who underwent ESDS for intractable MD from January 2002 to March 2022. Clinical characteristics of patients, pure tone threshold, medical treatment method, and number of vertigo attacks before and after surgery were assessed. The improvement of hearing and vertigo was evaluated according to the 1995 American Academy of Otolaryngology-Head and Neck Surgery criteria.
Results
Of the 33 patients, the average follow-up period was 21.2 months, with immediate follow-up within 2 months (28 patients), short term between 2 and 6 months (27 patients), and long term at 12 months or later (29 patients). In the immediate hearing threshold, both air conduction and bone conduction showed slight deterioration, but there was no significant change in the long-term hearing threshold. At long-term follow-up, 12 patients (41.4%) were able to live without medication, and 18 patients (62.1%) showed improvement in their vertigo symptoms. In addition, patients who showed improvement in hearing also showed improvement in vertigo at the same time.
Conclusions
ESDS in intractable MD is a relatively safe and effective treatment method for reducing vertigo attack without worsening hearing threshold.

Keyword

Meniere disease; Endolymphatic sac; Surgical decompression; Vertigo; Endolymphatic hydrops; 메니에르병; 내림프낭; 감압술; 현훈; 내림프수종