title: Effects of posterior tympanotomy with steroids at round window on hearing recovery after revision surgery for intractable Meniere's disease.
abstract: CONCLUSIONS
  At the second postoperative year, there were no significant differences between results for vertigo and hearing after endolymphatic sac drainage with steroid instillation surgery (EDSS) and EDSS with posterior tympanotomy with steroids at the round window (EDRW). In particular, as regards hearing recovery to the preoperative level, the periods after EDRW were shorter than those after the second EDSS.
  
  
  OBJECTIVE
  Patients sometimes faces recurrent problems years after EDSS due to endolymphatic sac closure and/or disease progression. In the present study, we examined the effects of EDRW on vertigo and hearing after revision surgery for intractable relapsed Meniere's disease.
  
  
  METHODS
  Sixteen patients with Meniere's disease had revision surgery due to intractable recurrence of disease, and were followed up regularly at least for 2 years. As revision surgery, EDSS was performed repeated in eight cases and EDRW was performed in the other eight. There were no significant differences between the patients' backgrounds in the two groups.
  
  
  RESULTS
  Periods of hearing recovery to the preoperative level were 11.5 ± 4.4 months after the first EDSS, although it took 16.4 ± 2.6 months longer after revision surgery with the second EDSS (p = 0.038 < 0.05: first EDSS vs second EDSS) and was 10.0 ± 3.3 months shorter after revision surgery with EDRW (p = 0.010 < 0.05: second EDSS vs EDRW).
authors.affiliation: Department of Otolaryngology - Head and Neck Surgery, Nara Medical University , Nara , Japan.
authors.forename: Masaharu
authors.initials: M
authors.lastname: Sakagami
authors.forename: Tadashi
authors.initials: T
authors.lastname: Kitahara
authors.forename: Taeko
authors.initials: T
authors.lastname: Ito
authors.forename: Ichiro
authors.initials: I
authors.lastname: Ota
authors.forename: Tadashi
authors.initials: T
authors.lastname: Nishimura
authors.forename: Ari
authors.initials: A
authors.lastname: Nishimura
authors.forename: Shintaro
authors.initials: S
authors.lastname: Otsuka
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Yamanaka
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D004712:Endolymphatic Sac / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006309:Hearing; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000601:surgery*; D008875:Middle Aged; D013506:Otologic Surgical Procedures; D020127:Recovery of Function; D012086:Reoperation; D012405:Round Window, Ear / Q000601:surgery*; D014717:Vertigo / Q000601:surgery
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone
keywords: Endolymphatic sac drainage; hearing; recurrence; revision surgery