Three new surgeries for treatment of intractable Meniere's disease.
OBJECTIVE
This study aimed to describe the rationales for and preliminary results of three new types of surgery for the treatment of intractable Meniere's disease, all involving insertion of a capillary tube into the endolymphatic duct. This study also aimed to compare the contrasting surgical strategies of endolymphatic sac enhancement versus sac supplantation.


METHODS
The study design was a retrospective review of 129 surgeries conducted by the author at Chang Gung Memorial Hospital since 1993: 51 cases of Huang/Gibson inner ear shunt implantation, 52 cases of intraductal capillary tube implantation (ICTI), and 26 cases of ICTIin combination with endolymphatic sac ballooning surgery (ESBS).


METHODS
This study is limited to patients with classic Meniere's disease whose vertiginous symptoms were disabling and refractory to dietetic and medical treatment.


METHODS
Comparison of preoperative and postoperative conditions (e.g., vertigo control, hearing, disability) using American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) 1985 criteria and chi-square statistical method was measured.


RESULTS
After 1 year of follow-up, use of the Huang/Gibson shunt resulted in a 94.1% vertigo control rate (complete or substantial) and fairly good hearing results, ICTI by itself resulted in an 88.5% rate of vertigo control and relatively unremarkable hearing results, and the ICTI in combination with ESBS (ICTI/ESBS) achieved a vertigo control rate of 96.1% in addition to good hearing results.


CONCLUSIONS
The 1-year follow-up results for Huang/Gibson shunt implantation and sac-preserving ICTI/ESBS have approximately duplicated the excellent performance of the Arenberg implant after the same follow-up period, perhaps attributable in part to enhancement of endolymph flow through the endolymphatic duct.
Huang
T S
TS
Department of Otolaryngology, Chang Gung University School of Medicine, Chang Gung Memorial Hospital, Taipei, Taiwan, Republic of China.
D000328:Adult; D000368:Aged; D002404:Catheterization; D004711:Endolymphatic Duct / Q000601:surgery; D004713:Endolymphatic Shunt / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006311:Hearing Disorders / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D011182:Postoperative Care; D011300:Preoperative Care; D019919:Prosthesis Implantation; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome