Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2013
Endolymphatic sac surgery versus intratympanic gentamicin for the treatment of intractable Ménière's disease: a retrospective review with survey.
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Paradis Josee, Hu Amanda, Parnes Lorne S
Аннотация
OBJECTIVES: 1) To review a 10-year experience of endolymphatic sac surgery (ESS) and intratympanic gentamicin (ITG) for intractable Ménière's disease (MD), and 2) to compare preoperative and postoperative outcomes.
DESIGN: Retrospective chart review and survey.
SETTING: Tertiary care center.
PATIENTS: Patients treated with ESS or ITG between 1997 and 2007 at London Health Sciences Centre were eligible for recruitment.
INTERVENTIONS: ESS or ITG.
MAIN OUTCOMES: 1) 1995 American Academy of Otolaryngology-Head and Neck Surgery hearing stage, vertigo class, and functional level; and 2) a 40-item validated quality-of-life questionnaire (MD Outcome Questionnaire).
STATISTICAL ANALYSES: Chi-squared and t tests.
RESULTS: Sixty-seven patients were recruited (n = 30 ESS; n = 37 ITG). Preoperatively, the ITG group had poorer hearing stage (p = 0.03). There were no differences between groups on preoperative functional level and QOL measures. Postoperatively, ESS patients reported more tinnitus (p = 0.003) and aural fullness (p = 0.01). There were no differences in posttreatment vertigo class. Secondary treatment was required for 27% of patients in the ESS compared with 3% in the ITG. Posttreatment hearing remained unchanged for the ITG and was overall decreased in the ESS group (p = 0.03). Participants in the ITG reported better postoperative functional levels (p = 0.02) and higher global (p = 0.04), social (p = 0.001), and overall QOL scores (p = 0.03).
CONCLUSION: ITG, compared with ESS, reveals better posttreatment functional levels, and superior global, social, and overall QOL scores. Although no statistical difference in vertigo class, a clinical difference is observed.
DESIGN: Retrospective chart review and survey.
SETTING: Tertiary care center.
PATIENTS: Patients treated with ESS or ITG between 1997 and 2007 at London Health Sciences Centre were eligible for recruitment.
INTERVENTIONS: ESS or ITG.
MAIN OUTCOMES: 1) 1995 American Academy of Otolaryngology-Head and Neck Surgery hearing stage, vertigo class, and functional level; and 2) a 40-item validated quality-of-life questionnaire (MD Outcome Questionnaire).
STATISTICAL ANALYSES: Chi-squared and t tests.
RESULTS: Sixty-seven patients were recruited (n = 30 ESS; n = 37 ITG). Preoperatively, the ITG group had poorer hearing stage (p = 0.03). There were no differences between groups on preoperative functional level and QOL measures. Postoperatively, ESS patients reported more tinnitus (p = 0.003) and aural fullness (p = 0.01). There were no differences in posttreatment vertigo class. Secondary treatment was required for 27% of patients in the ESS compared with 3% in the ITG. Posttreatment hearing remained unchanged for the ITG and was overall decreased in the ESS group (p = 0.03). Participants in the ITG reported better postoperative functional levels (p = 0.02) and higher global (p = 0.04), social (p = 0.001), and overall QOL scores (p = 0.03).
CONCLUSION: ITG, compared with ESS, reveals better posttreatment functional levels, and superior global, social, and overall QOL scores. Although no statistical difference in vertigo class, a clinical difference is observed.