A comparison of endolymphatic shunt surgery and intratympanic gentamicin for meniere's disease.
Laryngoscope
; 130(10): 2455-2460, 2020 10.
Article
in En
| MEDLINE
| ID: mdl-31808957
ABSTRACT
OBJECTIVE:
To report audiovestibular outcomes following endolymphatic shunt surgery (ELS) and intratympanic gentamicin injections (ITG) in patients with Meniere's disease (MD). STUDYDESIGN:
Retrospective matched cohort studyMETHODS:
Patients with MD refractory to medical management between 2004 and 2017 were reviewed 44 patients underwent ELS and had outcomes available, while 27 patients underwent ITG and had outcomes available. Mean follow-up durations for the ELS and ITG groups were 39.1 and 43.3 months, respectively. Twenty-six patients from the ELS group and 24 patients from the ITG group were then included in a pretreatment hearing- and age-matched analysis. Main outcome measures were successful control of vertigo, pure-tone average (PTA; 0.5, 1, 2 and 4 kHz), word recognition score (WRS), and treatment complications.RESULTS:
A matched analysis showed vertigo control rates of 73.1% in the ELS group and 66.8% in the ITG group, which were not significantly different (P = .760). The change in PTA following treatment was statistically similar between the ELS group (6.2 dB) and ITG group (4.6 dB) (P = .521), while the change in WRS for the ELS group (+3.9 %) was significantly more favorable than the ITG group (-13.6 %) (P = .046). Chronic post-treatment unsteadiness was reported in 25.0% of the ITG group and was not encountered in the ELS group (P = .009).CONCLUSION:
ELS provided successful vertigo control at least as well as ITG with a lower incidence of audiovestibular complications. LEVEL OF EVIDENCE 4 Laryngoscope, 1302455-2460, 2020.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Endolymphatic Shunt
/
Protein Synthesis Inhibitors
/
Gentamicins
/
Meniere Disease
Type of study:
Observational_studies
/
Risk_factors_studies
Limits:
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Laryngoscope
Journal subject:
OTORRINOLARINGOLOGIA
Year:
2020
Document type:
Article
Affiliation country:
Estados Unidos