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Is Menière's Disease a Contraindication to Stapedectomy?
Pedrom C Sioshansi1, Amy E Schettino2, Dennis I Bojrab1
1Department of Neurotology, Michigan Ear Institute, St. John Providence Hospital and Medical Centers, Farmington Hills, Michigan.
Summary
Stapedectomy surgery for otosclerosis in patients with Menière's disease significantly improves hearing outcomes. While most patients experience better hearing, some may still have fluctuating hearing loss characteristic of Menière's disease.
Area of Science:
- Otolaryngology
- Neurosurgery
- Audiology
Background:
- Otosclerosis is a common cause of conductive hearing loss.
- Menière's disease is a disorder of the inner ear causing vertigo and fluctuating hearing loss.
- The surgical management of otosclerosis in patients with co-existing Menière's disease requires careful consideration.
Purpose of the Study:
- To evaluate the surgical outcomes of stapedectomy in patients diagnosed with both otosclerosis and Menière's disease.
- To assess the impact of stapedectomy on hearing levels and complication rates in this specific patient cohort.
Main Methods:
- A retrospective case review was conducted at a tertiary referral center.
- Data from patients who underwent stapedectomy for otosclerosis between 2010 and 2017, and also had Menière's disease, were analyzed.
- Pre- and postoperative hearing was assessed using air conduction (AC) and bone conduction (BC) pure-tone averages (PTA), air-bone gap (ABG), and word recognition scores (WRS).
Main Results:
- Fifteen patients with otosclerosis and Menière's disease underwent stapedectomy.
- Significant improvements were observed in mean AC PTA (43 dB to 25 dB, p=0.0007) and ABG (20 dB to 5 dB, p=0.0001).
- No significant changes in BC PTA or WRS were noted; two patients experienced postoperative hearing fluctuations, one resolving with steroids.
Conclusions:
- Stapedectomy offers excellent hearing improvement for the majority of patients with otosclerosis and Menière's disease.
- Postoperative hearing fluctuations can occur, consistent with the natural course of Menière's disease.
- Menière's disease should not be considered an absolute contraindication for stapes surgery in patients with otosclerosis.
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