INTRODUCTION
Meniere’s disease (MD) is an inner ear disorder characterized by
intermittent episodes of vertigo lasting from minutes to hours,
incurring fluctuating sensorineural hearing loss, tinnitus, and aural
pressure in the affected ear. Numerous treatment options are currently
used with the aim of reducing the severity and incidence of vertigo
attacks, preventing disease progression, and treating the effects of end
organ damage such as hearing loss, tinnitus, and chronic imbalance, and
providing symptomatic relief1. Lifestyle modification
and medical treatment were recommended as the first line of care
provided to those patients. More than 85% of patients with MD are
helped by such treatment strategies2. However, vertigo
persists despite an optimal conservative treatment in approximately 10%
of cases. These cases are considered to have intractable
MD3. The quality of life of these patients were
seriously affected by the symptoms of the disease, especially during
vertigo episodes. A common problem is the difficulty in controlling
vertigo effectively while preserving hearing. To date, many different
methods have been attempted to treat these patients, including a variety
of surgeries. Endolymphatic sac surgery has been proven safe and
effective in the alleviation of intractable vertigo in only 50% to 75%
of patients4-6. However, Thomsen and colleagues
concluded that endolymphatic sac surgery presented no advantages
compared with a placebo operation7. Semicircular canal
occlusion has been used as an alternative treatment in intractable
benign paroxysmal positional vertigo with varying degrees of success.
The surgery aims to ablate movement of the endolymph in the canals and
therefore to eliminate vertigo attacks aroused by rotational movements.
It is also a prospective method in vertigo management in patients with
MD.
The aim of this study is to evaluate the effectiveness of triple
semicircular canal occlusion (TSCO) combined with endolymphatic sac
decompression (ESD) in controlling vertigo attacks, tinnitus, and aural
fullness, and to evaluate its effect on hearing level and equilibrium
function rehabilitation. Here, we present a retrospective analysis on 46
patients with MD who underwent TSCO combined with ESD. The analysis
includes symptom control and management and markers of functional
preservation.