Health Utility Improves After Surgery for Superior Canal Dehiscence Syndrome.
OBJECTIVE
Health utility value (HUV) is an outcome measure used to calculate quality adjusted life years (QALYs) and to determine cost-effectiveness of medical treatments. Herein, we measure HUV in patients with superior canal dehiscence syndrome (SCDS) before and after surgical repair. Health utility values of patients with SCDS are compared to normative data of the general United States population.


METHODS
Retrospective review of prospectively collected data.


METHODS
Adult patients with SCDS.


METHODS
Tertiary referral center.


METHODS
SCD repair via middle fossa craniotomy or transmastoid approaches.


METHODS



METHODS
change in HUV, as measured by the Short-Form 6-Dimension questionnaire.


RESULTS
autophony index (AI), dizziness handicap inventory (DHI), and hearing handicap inventory (HHI).


RESULTS
Fifty-one patients with SCDS were enrolled, 23 underwent surgical repair. Mean HUV in patients with SCDS is significantly lower than the general U.S.


METHODS
0.68 (SD = 0.13) versus 0.80 (0.29), p < 0.01, respectively. Patients electing to undergo surgical repair had similar values relative to nonoperated patients: 0.65 (0.13) versus 0.71 (0.14), p = 0.20, respectively. At mean follow-up of 12 months (range 3-39), postoperative HUV improved to 0.79 (0.12), p < 0.01. AI decreased (improved) after repair: 32.7 (28.0) to 4.8 (8.3), p < 0.001. DHI and HHI did not change significantly after surgery, p > 0.14. Nonoperated patients had no significant change in HUV during a mean follow-up period of 21 months (range 9-39), p = 0.33.


CONCLUSIONS
SCDS patients have significantly lower HUV compared with the general U.S.


METHODS
HUV demonstrated improvement after surgery. Nonoperated patients have ongoing impaired quality of life.
*Department of Otology and Laryngology, Harvard Medical School †Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, U.S.A.
Aaron K
AK
Remenschneider
Maryanna
M
Owoc
Elliott D
ED
Kozin
Michael J
MJ
McKenna
Daniel J
DJ
Lee
David H
DH
Jung
D000328:Adult; D005260:Female; D006801:Humans; D007759:Labyrinth Diseases / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D013517:Otorhinolaryngologic Surgical Procedures; D019057:Quality-Adjusted Life Years; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000601:surgery; D011795:Surveys and Questionnaires; D016896:Treatment Outcome