Evaluation of vestibular function following endolymphatic sac surgery

Area of Science:

• Otolaryngology
• Neuroscience
• Vestibular System Research

Background:

• Menière's disease (MD) is a complex inner ear disorder.
• Current treatments for MD often aim to manage symptoms and preserve function.
• Endolymphatic sac surgery (ELSS) is a surgical option for MD refractory to medical management.

Purpose of the Study:

• To objectively evaluate vestibular function following endolymphatic sac surgery (ELSS) for Menière's disease (MD).
• To compare pre- and postoperative outcomes using videonystagmography (VNG), vestibular evoked myogenic potentials (VEMP), and video head-impulse test (VHIT).
• To assess vertigo control, hearing outcomes, and quality of life (QoL) post-ELSS.

Main Methods:

• Inclusion of patients with definite MD (AAO-HNS criteria).
• Surgical intervention involved ELSS (sac decompression or opening).
• Comparative analysis of pre- and postoperative VNG, VEMP, and VHIT results.

Main Results:

• Significant preservation of vestibular function demonstrated by VNG and VHIT.
• No significant change in VEMP responses (P13/N23, N1/P1 waves).
• 67% of patients achieved good vertigo control; improved QoL scores (p < 0.0001).

Conclusions:

• ELSS is a conservative surgical approach for MD that preserves vestibular function.
• The procedure leads to improved vertigo control, hearing preservation, and enhanced QoL.
• ELSS remains a valuable first-line surgical option for medically refractory MD.