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New marsupialization technique in endolymphatic sac surgery.

ABSTRACT: Objectives:The aim of the present study was to describe and evaluate the results of a new technique in endolymphatic sac decompression surgery. Methods:Forty-three patients with intractable unilateral Meniere's disease were selected. Endolymphatic sac was identified after simple mastoidectomy, and its lateral layer was incised, using a sickle knife. Outer layer of the sac was turned around and placed under the anterior bony border. Results:Mean duration of the follow-up was 24?months. Mean tinnitus handicap index, pure tone average (PTA) on thresholds at 500, 1000, 2000, and 4000?Hz, mean speech reception threshold, mean speech discrimination score, hearing stage, and mean vertigo score before and after surgery were evaluated. Conclusion:The new marsupialization technique with anterior bony border is a safe and effective way to improve tinnitus, vertigo, and ear fullness among these patients. According to PTA and hearing stage, this surgery can control progressive hearing loss. Level of Evidence:3.

SUBMITTER: Daneshi A

PROVIDER: S-EPMC7314464 | biostudies-literature | 2020 Jun

REPOSITORIES: biostudies-literature

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New marsupialization technique in endolymphatic sac surgery.

Daneshi Ahmad A Hosseinzadeh Farideh F Mohebbi Saleh S Mohseni Mohammad M Mohammadi S Saeed SS Asghari Alimohamad A

Laryngoscope investigative otolaryngology 20200526 3

<h4>Objectives</h4>The aim of the present study was to describe and evaluate the results of a new technique in endolymphatic sac decompression surgery.<h4>Methods</h4>Forty-three patients with intractable unilateral Meniere's disease were selected. Endolymphatic sac was identified after simple mastoidectomy, and its lateral layer was incised, using a sickle knife. Outer layer of the sac was turned around and placed under the anterior bony border.<h4>Results</h4>Mean duration of the follow-up was ...[more]

PMID: 32596499

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Project description:IntroductionOutcomes of surgery for Ménière's disease (MD) remain discordant. Recently, a new surgical procedure in which the endolymphatic duct is clipped was proposed. To date, only one prospective trial assessing this technique was published, yielding promising results. This protocol describes a prospective, double-blinded, randomised controlled trial that will be carried out to assess the effectiveness of this surgical intervention.MethodsEighty-four patients with intractable MD will be recruited from 13 hospitals in the Netherlands. Intraoperatively, randomisation will determine whether endolymphatic duct blockage (EDB) or endolymphatic sac decompression (ESD) will be performed. Randomisation will be 1:1 stratified for gender and duration of MD (recent-onset versus mature MD). All participants receive vestibular rehabilitation after surgery. Patients are followed up during 1 year after surgery. Follow-up visits will take place at 1 week, 3 months, 6 months and 12 months after surgery. The main study endpoint is proportion of patients who are free of vertigo spells at 12 months postoperatively. Secondary parameters include cumulative number of vertigo bouts, co-intervention, tinnitus, hearing, quality of life, cost effectiveness and a budget impact analysis. Total duration of the study is 4 years.AnalysisThe primary analysis will follow the intention-to-treat principle. For the primary outcome, a χ2 test will be performed. Secondary outcomes will be analysed using a linear mixed model (EDB versus decompression group) at the different time measurement point.Ethics and disseminationThis study was reviewed and approved by a board of specialists before funding was obtained, as well as by the Medical Research Ethics Committee Leiden-The Hague-Delft and the boards of all participating centres. Results of this study will be published in international peer-reviewed scientific journals and will be presented on (inter)national scientific conferences and meetings.Trial registration numbersNL9095 and ISRCTN12074571; Pre-Results.

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New marsupialization technique in endolymphatic sac surgery.

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New marsupialization technique in endolymphatic sac surgery.

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