[Individual management of Meniere's disease and evaluation of functional outcome]

Ying Chen, Jun Yang, Hao Wu, Qi Huang, Zhaoyan Wang, Zhihua Zhang
Journal of Clinical Otorhinolaryngology, Head, and Neck Surgery 2011, 25 (16): 721-5

OBJECTIVE: To investigate individual management for Meniere's disease and analyze outcomes of nonsurgical and surgical management of Meniere's disease.

METHOD: Patients with Meniere's disease were staged according to hearing and quality of life. The individual management according to the staging was established, including outpatient treatment (lifestyle change, medical management and intratympanic steroids), endolymphatic sac decompression or drainage, vestibular neurectomy and labyrinthectomy. The characteristics of patients who underwent surgical management were analyzed. The functional outcomes of surgery in dizziness, hearing loss and quality of life were evaluated for 12-month postoperative follow-up.

RESULT: Twenty patients underwent intratympanic injection of dexamethasone. Dizziness improved in 70% (14/20), tinnitus improved in 41% (7/17), and aural fullness improved in 36% (4/11). There were 55 patients who underwent surgical managements for 57 times. Endolymphatic sac decompression or drainage was carried out in 27 patients for 28 times, vestibular neurectomy in 26 patients and labyrinthectomy in 3 patients. Vertigo control rate was 75% in patients with endolymphatic sac decompression or drainage, 100% in vestibular neurectomy and 100% in labyrinthectomy at 12-month postoperative follow-up.

CONCLUSION: The non-surgical management and endolymphatic sac decompression or drainage can improve vertigo and ameliorate quality of life. Vestibular neurectomy and labyrinthectomy are effective surgical managements to eliminate vertigo. The management of Meniere's disease depends on several factors: stages of vertigo and hearing, quality of life, surgical contraindications and subjective desire. Therefore, the management for Menieres disease must be individualized for each patient.

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