title: Current evidence for endolymphatic sac surgery in the treatment of Meniere's disease: a systematic review.
abstract: This paper aims to identify emerging evidence for endolymphatic sac surgery (ESS) in the treatment of Meniere's disease since the landmark study by Thomsen et al, published in 1998 (conducted from 1981 to 1989). Using the MEDLINE database (PubMed), a systematic review of the literature published from January 1990 to June 2014 was performed. We included all English-language, peer-reviewed randomised controlled trials (RCTs) and controlled studies. Single-arm cohort studies were included if the sample size was ≥ 90 with a response rate > 60%. Altogether, 11 studies fulfilled our inclusion criteria; one was an RCT, two were controlled trials and eight were single-arm cohort studies. There currently exists a low level of evidence for the use of ESS in the treatment of Meniere's disease. Further studies, in particular RCTs and/or controlled studies, are required to fully evaluate this modality. However, there are difficulties in designing a valid placebo and achieving adequate blinding of observers and investigators.
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Tan Tock Seng Hospital, Singapore.
authors.forename: Ming Yann
authors.initials: MY
authors.lastname: Lim
authors.affiliation: Department of Internal Medicine, Tan Tock Seng Hospital, Singapore.
authors.forename: Margaret
authors.initials: M
authors.lastname: Zhang
authors.affiliation: Department of Otolaryngology and Head and Neck Surgery, Changi General Hospital, Singapore.
authors.forename: Heng Wai
authors.initials: HW
authors.lastname: Yuen
authors.affiliation: Mount Elizabeth Medical Centre, Singapore.
authors.forename: Jern-Lin
authors.initials: JL
authors.lastname: Leong
mesh_terms: D004712:Endolymphatic Sac / Q000601:surgery*; D006801:Humans; D008575:Meniere Disease / Q000601:surgery*; D013506:Otologic Surgical Procedures / Q000379:methods*
keywords: Meniere’s disease; endolymphatic sac surgery