Abstract
BackgroundThe clinical efficacy of triple semicircular canal occlusion (TSCO) and vestibular nerve resection (VNS) for patients with Ménière's disease has been unclear.ObjectiveTo explore changes in vestibular symptoms after TSCO and its advantages compared to the classical operation of VNS in patients with Menière's disease.MethodsIn total, 36 patients with Menière's disease performed TSCO or VNS at Shanghai Jiao Tong University Affiliated Sixth People's Hospital, China from May 2005 to July 2021, and all of them were enrolled in our study. Twelve of them underwent TSCO, 23 underwent VNS, and 1 had both treatments. We compared the demographic parameters, clinical symptoms, and selected test results between the two surgical methods. Ten patients each who underwent TSCO and VNS completed the follow-up. We collected and compared data pertaining to changes in vestibular symptoms.ResultsNo significant difference in demographic parameters, clinical symptoms, or auditory or vestibular test results was detected between the two groups preoperatively. The TSCO group with vertigo as the main complaint experienced less residual paroxysmal dizziness after surgery than the VNS group (P = 0.020). Also, 57% of the patients in the VNS group had unsteadiness after surgery, while no such problems were reported in the TSCO group (P = 0.025).ConclusionsOur study shows that TSCO controls vertigo in most Menière's disease patients, and also has the advantage of lower rates of postoperative paroxysmal dizziness and unsteadiness than VNS. Thus, TSCO may be an effective surgery for refractory Menière's disease.
Highlights
Menière’s disease is an inner ear disorder characterized by two or more episodes of vertigo associated with fluctuating lowand medium-frequency hearing loss (HL), tinnitus, and aural fullness
Dizziness Handicap Inventory (DHI) results, we evaluated the patients’ quality of life physically, emotionally, and functionally; a large group difference was found in all three domains (P = 0.022, 0.025, and 0.013, respectively)
We found no significant difference between triple semicircular canal occlusion (TSCO) and vestibular nerve resection (VNS) in terms of the ability to control vertigo
Summary
Menière’s disease is an inner ear disorder characterized by two or more episodes of vertigo associated with fluctuating lowand medium-frequency hearing loss (HL), tinnitus, and aural fullness. The disease is characterized by an impaired quality of life [4] and can lead to restricted activity due to refractory vertigo [5]. Both medical and surgical interventions are used in the treatment of Menière’s disease, to control vertigo attacks and preserve hearing and vestibular function [6]. The step of treatment is to reduce the number of attacks and relieve vertigo and dizziness symptoms via medications including betahistine, antihistamines, benzodiazepines, ginkgo biloba extract, and corticosteroids [8]; diuretics may be tried to reduce endolymphatic hydrops [9]. The clinical efficacy of triple semicircular canal occlusion (TSCO) and vestibular nerve resection (VNS) for patients with Ménière’s disease has been unclear
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