Endolymphatic sac decompression as a treatment for Meniere's disease.
OBJECTIVE
Endolymphatic sac decompression is a surgical treatment option for patients with medically intractable Meniere's disease. However, effectiveness is debated because published data show great variability. Outcome-based research studies are useful in incorporating the patient's perspective on the success of treatment. To further assess effectiveness of endolymphatic sac decompression, we performed a prospective study to examine both symptom-specific and general health outcomes.


METHODS
Prospective, observational outcome study.


METHODS
Nineteen patients with endolymphatic sac decompression responded to symptom-specific questionnaires and the Medical Outcomes Short-Form 36 Health Survey (SF-36) before and after surgery. Follow-up ranged from 6 to 58 months with a mean duration of 50 months.


RESULTS
Overall measures of physical health were significantly improved following endolymphatic sac decompression (P = .04), whereas overall measures of mental health were unchanged (P = .74). Role Physical and Social Functioning scores were significantly improved following endolymphatic sac decompression (P = .04 and P = .03, respectively). Study patients scored significantly lower (P < .05) than SF-36 normative data in 6 of 10 categories before endolymphatic sac decompression but patient scores were not significantly different from normal scores in all but one category (General Health) following endolymphatic sac decompression. The mean number of vertigo episodes was significantly reduced from an average of 8.3 times per month to an average of 2.6 times per month following endolymphatic sac decompression (P = .006). Ninety-five percent of patients (18 of 19 patients) reported improvement in symptoms (frequency, duration, or intensity) of vertigo and 37% (7 of 19 patients) reported complete resolution of vertigo.


CONCLUSIONS
Endolymphatic sac decompression significantly improved perception of physical health, as well as symptom-specific outcomes, in patients with medically intractable Meniere's disease.
Durland
William F
WF
Division of Otolaryngology-Head and Neck Surgery, Department of Surgery, University of Wisconsin, 600 Highland Avenue, Madison, WI 53792, U.S.A.
Pyle
G Mark
GM
Connor
Nadine P
NP
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D019299:Decompression, Surgical / Q000379:methods; D004712:Endolymphatic Sac / Q000503:physiopathology / Q000601:surgery*; D004713:Endolymphatic Shunt / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis / Q000601:surgery*; D008875:Middle Aged; D017060:Patient Satisfaction; D011183:Postoperative Complications / Q000453:epidemiology; D011446:Prospective Studies; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014717:Vertigo / Q000453:epidemiology*