Endolymphatic Duct Blockage: A Randomized Controlled Trial of a Novel Surgical Technique for Ménière's Disease Treatment. (January 2015)

• Record Type: Journal Article
• Authors: Saliba, Issam; Gabra, Nathalie; Alzahrani, Musaed; Berbiche, Djamal
• Is Part Of: Otolaryngology--head and neck surgery. Volume 152:Number 1(2015:Jan.)
• Page Start: 122
• Page End: 129
• Publication Date: 2015-01
• Subjects: Ménière's disease -- endolymphatic duct -- endolymphatic sac -- decompression -- vertigo -- hearing loss -- ear fullness -- tinnitus; Head -- Surgery -- Periodicals; Neck -- Surgery -- Periodicals; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/0194599814555840
• Languages: English
• ISSNs: 0194-5998

Abstract

Objectives: 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. Study Design: Prospective nonblinded randomized study. Setting: Tertiary medical center. Subjects and Methods: 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). Results: 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). Conclusion: 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.