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Long-term hearing results following vestibular surgery in Meniere's disease
J J Wazen1, J Spitzer, C Kasper
1Department of Otolaryngology-Head and Neck Surgery, Columbia-Presbyterian Medical Center, New York, New York 10032, USA.
Objectives:
The purpose of this study is to evaluate the long-term hearing changes following vestibular surgery in patients with Meniere's disease.
Study Design:
This is a retrospective analysis of patients operated on in a tertiary referral center setting.
Methods:
Preoperative, postoperative, and 3- to 9-year postoperative audiograms were analyzed in two patient groups. Twenty-one patients underwent posterior fossa vestibular neurectomy (VN) and five, mastoid endolymphatic sac decompression and shunt (ELS). All frequencies, four-frequency pure-tone averages (PTAs), spondee thresholds, and speech recognition scores were compared for operated ear against nonoperated ear of VN subjects. The results were subjected to a covariance analysis. VN and ELS patients whose hearing deteriorated from "serviceable" (PTA < or =70 dB hearing level) and speech recognition > or =30%) to nonserviceable status were compared using nonparametric statistics.
Results:
Progressive hearing loss beyond the rate of change of the normal contralateral ear was evident in all patients. Serviceable hearing dropped from 81% to 43% of patients an average of 4 years following VN.
Conclusions:
VN patients have significant hearing deterioration over time in the operated ear. This finding suggests that continued postoperative medical management is necessary for patients undergoing VN.