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.