Abstract
Objectives: Endolymphatic sac decompression (ELSD) is a surgical alternative for those patients with Meniere's disease that are resistant to medical therapy. This safe, nondestructive surgical option can be performed with and without shunt placement. The present retrospective study investigates the long-term efficacy of this surgical treatment with and without shunt placement.
Methods: Seventy-five patients who underwent ELSD with or without shunts were included in the present investigation based on availability of pre- and postoperative data. Four-tone average using .5, 1, 2, and 3 kHz and speech discrimination scores were used to compare hearing pre- and postoperatively. Postoperative vertigo was rated as absent, decreased, unchanged, and increased when compared to preoperative vertigo. The preoperative data were obtained within 6 months prior to surgery and postoperative data within 6-24 months following surgery.
Results: No improvement in hearing sensitivity was found postoperatively in either study group and no statistical difference was measured in hearing sensitivity between both groups. Vertigo was absent in 55%, decreased in 13%, unchanged in 15%, and increased in 17% of those patients not receiving a shunt. Vertigo in contrast was absent in 50%, decreased in 29%, unchanged in 14%, and increased in 7% of those patients with shunts.
Conclusion: These data suggest no benefit with regard to hearing. However, the data do suggest that postoperative vertigo in the shunt group is better controlled.
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