Endolymphatic sac surgery for hearing conservation in Meniere disease

Area of Science:

• Otolaryngology
• Neurosurgery
• Nephrology

Background:

• Meniere disease is a chronic inner ear disorder characterized by vertigo, hearing loss, tinnitus, and aural fullness.
• The pathophysiology of Meniere disease is not fully understood, but endolymphatic hydrops is considered a key factor.
• Surgical interventions aim to decompress or drain the endolymphatic sac to alleviate symptoms.

Purpose of the Study:

• To evaluate the efficacy of endolymphatic sac decompression and drainage using a Silastic shunt in Meniere disease patients.
• To determine if preoperative glycerol test results predict surgical outcomes.

Main Methods:

• Thirty-five patients diagnosed with Meniere disease underwent endolymphatic sac decompression and drainage with a Silastic sac-mastoid shunt.
• Patient outcomes were assessed using subjective questionnaires and objective audiometric studies (preoperative and postoperative).
• Patients were stratified based on positive or negative results from preoperative glycerol tests.

Main Results:

• Overall, 88.9% of patients with positive glycerol tests experienced significant relief from vertigo.
• Hearing was improved in 59.2% and stabilized in 18.5% of patients.
• Eight patients with negative glycerol tests showed no benefit from the surgery (P < .001).

Conclusions:

• Endolymphatic sac decompression with a Silastic shunt is an effective treatment for Meniere disease, particularly for patients with positive glycerol tests.
• The glycerol test is a valuable predictor of surgical success in managing vertigo associated with Meniere disease.
• The procedure offers significant potential for hearing conservation and vertigo symptom relief, leading to high patient satisfaction.