Simultaneous Cochlear Implantation and Labyrinthine Surgery for Meniere Disease: Endolymphatic Sac Decompression...

Area of Science:

• Otolaryngology
• Neurosurgery
• Audiology

Background:

• Medically refractory Meniere disease (MD) with vertigo and severe-profound hearing loss (SNHL) presents treatment challenges.
• Simultaneous labyrinthectomy/cochlear implantation (CI) is established, while endolymphatic sac decompression (ESD) and CI is less described.

Purpose of the Study:

• To compare outcomes of simultaneous or staged ESD/CI with simultaneous labyrinthectomy/CI in MD patients.
• To analyze vertigo control, hearing improvement, and complications for both surgical approaches.

Main Methods:

• Retrospective review of 18 MD patients (19 ears) from two tertiary centers.
• Inclusion criteria: frequent vertigo, SNHL, normal MRI, and controlled sodium intake.
• Analysis of demographic data, complications, audiometric, and vestibular outcomes.

Main Results:

• Vertigo attacks decreased in 71.4% of ESD/CI patients and 100% of labyrinthectomy/CI patients.
• ESD/CI showed significant hearing improvements (AzBio sentences, monosyllabic words).
• Labyrinthectomy/CI also demonstrated improved hearing outcomes (AzBio-Q sentences).

Conclusions:

• Simultaneous ESD/CI is a safe and effective option for Meniere disease patients with SNHL.
• Vestibular and hearing outcomes of ESD/CI are comparable to labyrinthectomy/CI.
• ESD/CI may offer a lower rate of complete vertigo resolution compared to labyrinthectomy/CI.