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Evaluation of vestibular function following endolymphatic sac surgery

  • Otology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Purpose

To evaluate objective vestibular function after endolymphatic sac surgery (ELSS) for Menière’s disease (MD), using comparative vestibular function tests: videonystagmography (VNG), vestibular evoked myogenic potentials (VEMP) and video head-impulse test (VHIT)

Methods

Patients with definite MD using the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) of 1995 criteria modified in 2015 and treated with ELSS (sac decompression or sac opening) were included. The primary outcome was the preservation of vestibular function, comparing pre- and postoperative vestibular function tests: VNG, VEMP, VHIT. Secondary outcomes were control of episodes of vertigo, hearing outcome using AAO-HNS criteria, and QoL using the Menière’s disease outcome questionnaire.

Results

73 patients were included in the study. We found a significant preservation of vestibular function as measured by VNG and VHIT. There was no statistical difference in the presence or absence of cervical and ocular (P13/N23 and N1/P1) waves on VEMP pre- and postoperatively. 67% of patients had good control of episodes of vertigo post-operatively, with significantly better results in the sac opening group (75%). There was no significant change in hearing postoperatively, and QoL scores were significantly improved after surgery (p < 0.0001).

Conclusion

Endolymphatic sac surgery (ELSS) is a conservative surgical treatment, which does not negatively impact vestibular function. It was associated with improved control of episodes of vertigo, preservation of hearing, and a clear improvement in QoL scores. Despite its pathophysiology not being fully understood, it remains a first-line procedure preserving vestibular function, for MD refractory to medical management.

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Authors and Affiliations

  1. Service d’ORL et de Chirurgie Cervico-Faciale, Centre Hospitalier Universitaire de Nantes (CHU), Hôtel-Dieu, 1, Place A. Ricordeau, BP 1005, 44093, Nantes Cedex 01, France

    Adrien Gendre, Kinnie Bourget-Aguilar, Catherine Calais, Florent Espitalier, Philippe Bordure & Guillaume Michel

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  1. Adrien Gendre
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  2. Kinnie Bourget-Aguilar
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Correspondence to Adrien Gendre.

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This study was approved by the local ethics committee (GNEDS—Groupe Nantais d’Ethique dans le Domaine de la Santé).

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Gendre, A., Bourget-Aguilar, K., Calais, C. et al. Evaluation of vestibular function following endolymphatic sac surgery. Eur Arch Otorhinolaryngol 279, 1193–1201 (2022). https://doi.org/10.1007/s00405-021-06743-3

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