Tack operation for idiopathic endolymphatic hydrops: an update.
This paper discusses an analysis of two groups of patients who underwent a tack operation for incapacitating recurrent attacks of vertigo due to idiopathic endolymphatic hydrops. Group I consisted of the first 140 patients operated on by one of the authors (D.T.R.C.). All were followed up for at least 5 years after the operation. However, between the 63rd and 166th postoperative months, 12 patients died of unrelated causes, and an additional 26 patients were lost to follow-up between the 70th and 119th postoperative months. The analysis was based on the condition of these patients up to the time of their death or the time that they were last contacted. The mean postoperative follow-up for the 140 patients was 12 years 9 months, and the range was 63 to 197 months. Group II consisted of 150 consecutive patients who had a tack operation performed by several consultants and residents in the Department of Otorhinolaryngology at the Mayo Clinic, and the opportunity for follow-up of at least 5 years existed for all patients. The patients who were lost to follow-up in the first 56 postoperative months were excluded from the analysis unless at the time they were last seen the operation had not controlled their vertigo, in which case the results were classified as failures. On this basis, 22 patients (15%) were excluded from the study, so that 128 patients remained in the analysis. The mean postoperative follow-up for this group was 9 years 4 months, with a range of 56 to 182 months. The following conclusions were reached. Vertigo was satisfactorily controlled in 79% of the patients in the two groups. Hearing was improved or maintained in 66% of the patients in Group I and 60% of the patients in Group II. A moderate-to-profound sensorineural hearing loss occurred in 34% of the patients in Group I and 40% of the patients in Group II. We consider the tack operation the conservative operation of choice in the management of idiopathic endolymphatic hydrops.
D005500:Follow-Up Studies; D006801:Humans; D008575:Meniere Disease / Q000601:surgery*; D008722:Methods; D013997:Time Factors