The effect of surgical treatment on Meniere's disease

Abstract

Objective:To compare functional outcomes after different surgical procedures in treatment of patients with Meniere's disease. Method:Patients with Meniere's disease were categorized into different groups mainly based on pure-tone average and functional level scale. Individualized surgical procedure was provided including endolymphatic sac shunt or decompression (ELSS), vestibular neurectomy (VN), labyrinthectomy (LC), semicircular canals plugging (SCP) and endolymphatic duct blockage (EDB). Result:Vertigo control rate of Grade A and B was 78.4% in patients with ELSS, 100.0% with VN, 100.0% with LC, 87.0% with SCP and 86.4% with EDB, respectively. Hearing was preserved with ELSS, VN and EDB postoperatively (P>0.05). But there was a significant hearing loss after SCP (P<0.05). Postoperatively, the QOL score improved significantly in each group (P<0.01). There were CSF leakage in 4 cases, temporary facial paralysis in 1 case, intracranial infection in 1 case, and abdominal hematoma in 5 cases in VN group after surgeries. None of the above complications occurred in other groups. Conclusion:Surgical Treatment choice for patients with Meniere's disease depends on several factors. The functional outcomes after different surgeries are generally satisfying. Residual hearing can be preserved effectively and the quality of life can be improved greatly. VN can effectively eradicate vertigo and preserve residual hearing, however, there is still a risk of some complications with this procedure. As for VN, retrolabyrinthine approach is more advantageous compared with retrosigmoid sinus approach.