Multiple perioperative interventions increase hearing preservation rate in triple semicircular canal occlusion for intractable Menierès disease: a retrospective matched case-control study
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Published on: October 11, 2024
Yupeng Liu1,2,3, Chun Chen1,2,3, Jingchun He1,2,3
1Department of Otolaryngology-Head and Neck Surgery, Xinhua Hospital, Shanghai Jiaotong University School of Medicine, Shanghai, China.
Background:
Triple semicircular canal occlusion (TSCO) is effective for vertigo control in Meniere's disease (MD), yet postoperative hearing deterioration remains a concern.
Objectives:
To determine whether a multimodal perioperative hearing-preservation strategy reduces hearing loss following TSCO.
Material And Methods:
In this retrospective matched case-control study, 28 TSCO patients receiving perioperative interventions-including intraoperative electrocochleography (ECochG), low-speed drilling, simultaneous canal fenestration, dexamethasone irrigation, and postoperative corticosteroids with betahistine-were matched 1:1 with controls. Pure-tone audiometry was conducted preoperatively and at 3 months postoperatively.
Results:
The intervention group demonstrated significantly smaller PTA change (5.10 ± 9.85 vs. 16.80 ± 15.20 dB HL, p < 0.05) and a higher hearing preservation rate (82.1% vs. 42.9%). Patients with intraoperative ECochG fluctuations experienced greater postoperative hearing deterioration (12.40 ± 6.48 vs. 0.52 ± 3.28 dB HL, p < 0.01).
Conclusions:
Multimodal perioperative interventions significantly improve short-term hearing outcomes after TSCO. ECochG monitoring provides real-time functional feedback and may reduce cochlear injury risk.
Significance:
These findings support standardized perioperative hearing-protection protocols and highlight ECochG as a valuable adjunct to improve the safety and acceptance of TSCO in refractory MD.
