Sac surgery results as a function of preoperative distress level

Functional outcomes and caloric response changes after endolymphatic sac decompression

OBJECTIVE

To evaluate caloric response changes after endolymphatic sac decompression (ESD), together with hearing outcomes and the functional benefit of the operation.

METHODS

A retrospective chart review of subjects who underwent endolymphatic sac decompression at a tertiary referral centre was performed. Data on audiological results, caloric testing, and functional level scale of the patients were analysed.

RESULTS

Twenty-eight patients who met our criteria were eligible for enrolment in the study. The average follow-up after surgery was 25 months (range, 13-41). Postoperative pure-tone threshold averages and reduced vestibular response values (RVR) were not significantly altered by ESD; whereas, functional level scores improved significantly.

CONCLUSION

Endolymphatic sac decompression is a surgical procedure that preserves hearing and vestibular function, and improves the daily functional level of patients with Ménière's disease. ESD can be preferred both in bilateral and unilateral disease because it does not alter vestibular function and preserves hearing.

Is endolymphatic sac surgery an efficient treatment of Menière's disease patients? A systematic literature search and meta-analysis

PURPOSE

The purpose of this work is to assess the treatment efficiency of endolymphatic sac surgery in patients with Menière's disease.

METHODS

This study provides a systematic literature review and meta-analysis based on the guidelines of the Cochrane Collaboration and the Preferred Reporting Items for Systematic reviews and Meta-Analyses protocol. The main inclusion criteria of the literature review were the classification categories according to the American Academy of Otolaryngology-Head and Neck Surgery guidelines of 1985 and 1995.

RESULTS

An effect of 9.25 dB postoperative weighted average hearing loss in surgically treated individuals is classified as "clinically not significant" according to American Academy of Otolaryngology-Head and Neck Surgery 85/95. In contrast, the deterioration by 26.23% in speech comprehension is considered as "clinically significant." An improvement of functional level scale assessment by two categories and vertigo control by assessment in category B can be observed.

CONCLUSION

The findings of this meta-analysis indicate that endolymphatic sac surgery may be beneficial as a treatment for Menière's disease in terms of a positive impact on functional level scale and vertigo control while yielding a negative impact on pure tone average hearing loss and on speech comprehension.