Evaluation of changes in endolymphatic volume after middle ear pressure therapy for intractable meniere's disease
Tadashi Kitahara1, Masaharu Sakagami1, Hiroshi Inui1,2
1Department of Otolaryngology- Head and Neck Surgery, Nara Medical University, Kashihara, Nara, Japan.
Background:
Nowadays, the endolymphatic space size can be evaluated by 3D-analysis of 3 T-MRI after intravenous injection of gadolinium enhancement.
Aims/Objectives:
In the present study, to elucidate the relationships between vertigo and endolymphatic hydrops (EH) volume after middle ear pressure therapy (MEPT), we investigated changes in EH volume after MEPT for intractable Meniere's disease (MD) by means of the inner ear MRI (ieMRI) in relation to clinical results.
Materials And Methods:
We enrolled 202 successive definite MD cases with intractable vertiginous symptoms from 2015 to 2020, assigning Group-I of MEPT, and Group-II of endolymphatic sac drainage (ELSD). Ninety patients completed the planned 2-year-follow-up, which included assessment of vertigo frequency and changes in EH volume using ieMRI (Group-I/MEPT: n = 40; Group-II/ELSD: n = 50).
Results:
Two years after surgery, vertigo was completely controlled in 77.5% of patients in Group-I and 90.0% in Group-II. Hearing improved by >10 dB in 7.5% of patients in Group-I and 24.0% in Group-II. ELS ratios were significantly reduced after treatments of Group-I and Group-II only in the vestibule.
Conclusions:
The obtained results indicate that MEPT as well as ELSD could be a good treatment option for patients with intractable MD.
