Long-term outcome of Ménière's disease: endolymphatic mastoid shunt versus natural history.
This retrospective study evaluates the outcome of 38 patients with intractable Ménière's disease with a minimum of 7 years follow-up. Twenty underwent endolymphatic-mastoid shunt (EMS) and 18 were offered surgery but declined (natural history, NH, group). At the last control, 85% of the patients who were operated on (EMS group) and 74% of the NH patients had complete or substantial control of vertigo. The difference between the two groups was not significant. However, it was significant at 2 and 4 years follow-up. At 2 years, EMS patients had complete or substantial control of vertigo in 65% of the cases, at 4 and 6 years in 85% of the cases. Only 32 % of the NH patients had complete or substantial control of vertigo at 2 years. This percentage rose to 50% at 4 years and to 74% at 6 years. Hearing results in the two groups were not significantly different. Tinnitus disappeared or decreased in 56% of the EMS patients and in 18% of the NH patients. Sixty-seven percent of the EMS patients and 29% of the NH patients reported that their aural fullness was abolished. In conclusion, over the years, approximately 8 out of 10 of our patients with Ménière's disease achieved complete or substantial control of vertigo; however, this reduction was observed earlier in EMS patients than in those who declined surgery.
Quaranta
A
A
Department of Ophtalmology and Otolaryngology, University of Bari, Italy. audiolog@cimedoc.uniba.it
Marini
F
F
Sallustio
V
V
D000328:Adult; D000368:Aged; D001301:Audiometry, Pure-Tone; D018450:Disease Progression; D004713:Endolymphatic Shunt / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006314:Hearing Loss, Conductive / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008416:Mastoid / Q000601:surgery*; D008575:Meniere Disease / Q000150:complications / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D013063:Speech Discrimination Tests; D013997:Time Factors; D014012:Tinnitus / Q000175:diagnosis / Q000209:etiology; D014717:Vertigo / Q000175:diagnosis / Q000209:etiology