Endolymphatic sac-vein decompression for intractable Meniere's disease: long term treatment results.
OBJECTIVE
We sought to determine the long-term efficacy of endolymphatic sac-vein decompression surgery on patients with classic Meniere's disease.


METHODS
Using the 1995 American Academy of Otolaryngology-Head and Neck Surgery Committee on Hearing and Equilibrium criteria, starting stage, functional level, vertigo class, and hearing results were addressed. We studied 68 patients with classic Meniere's disease from a tertiary, private otology-neurotology practice. Patient data were gathered by retrospective chart review, questionnaire, and patient interview. All patients underwent endolymphatic sac-vein decompression with an average follow-up period of 55 months.


RESULTS
Median functional level before surgery was level 4, improving to level 2 after surgery. Eighty-one percent of patients showed improvement in functional level, 12% remained stable, and 7% declined. Long-term vertigo control was 47% in class A, 25% in class B, 9% in class C, 3% in class D, and 16% in class F. Twenty percent of patients were in hearing stage I Meniere's disease; 31%, stage II; 44%, stage III; and 5%, stage IV. Eighteen percent of patients showed improvement in hearing class, 64% were stable, and 18% declined.


CONCLUSIONS
Endolymphatic sac-vein decompression surgery is a safe, nondestructive surgical option for Meniere's disease that offers durable control of vertigo and stabilization of hearing for the majority of symptomatic patients.


CONCLUSIONS
The beneficial long-term outcome of the endolymphatic sac-vein decompression supports its continued use as a first-line treatment option in intractable Meniere's disease.
Ostrowski
Vincent B
VB
Michigan Ear Institute, Farmington Hills 48334, USA.
Kartush
Jack M
JM
D000328:Adult; D000368:Aged; D019299:Decompression, Surgical; D004712:Endolymphatic Sac / Q000098:blood supply*; D005500:Follow-Up Studies; D006801:Humans; D008575:Meniere Disease / Q000601:surgery*; D008875:Middle Aged; D012189:Retrospective Studies; D013997:Time Factors; D014680:Veins