Kayoko Higashi-Shingai1, Takao Imai2, Tomoko Okumura3, Atsuhiko Uno4, Tadashi Kitahara5, Arata Horii6, Yumi Ohta3, Yasuhiro Osaki7, Takashi Sato3, Suzuyo Okazaki8, Takefumi Kamakura9, Yasumitsu Takimoto10, Yoshiyuki Ozono3, Yoshiyuki Watanabe11, Ryusuke Imai3, Yukiko Hanada12, Kazuya Ohata3, Ryohei Oya3, Hidenori Inohara3. 1. Department of Otolaryngology, Yao Municipal Hospital, Osaka, Japan. 2. Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. Electronic address: timai@ent.med.osaka-u.ac.jp. 3. Department of Otorhinolaryngology - Head and Neck Surgery, Osaka University Graduate School of Medicine, Osaka, Japan. 4. Department of Otorhinolaryngology - Head and Neck Surgery, Osaka General Medical Center, Osaka, Japan. 5. Department of Otorhinolaryngology - Head and Neck Surgery, Nara Medical University, Nara, Japan. 6. Department of Otorhinolaryngology - Head and Neck Surgery, Niigata University Graduate School of Medicine and Dentistry, Niigata, Japan. 7. Department of Otolaryngology, Kinki University Faculty of Medicine, Japan. 8. Department of Otolaryngology, Osaka City General Hospital, Osaka, Japan. 9. Department of Otorhinolaryngology, Otemae Hospital, Osaka, Japan. 10. Department of Otolaryngology, Osaka Police Hospital, Osaka, Japan. 11. Department of Diagnostic and Interventional Radiology, Osaka University Graduate School of Medicine, Osaka, Japan. 12. Department of Otolaryngology, National Hospital Organization Osaka National Hospital, Osaka, Japan.
Abstract
OBJECTIVE: This study was performed to determine whether endolymphatic sac surgery improves vestibular and cochlear endolymphatic hydrops 2 years after sac surgery and to elucidate the relationship between the degree of improvement of endolymphatic hydrops and the changes in vertigo symptoms, the hearing level, and the summating potential/action potential ratio (-SP/AP ratio) by electrocochleography (ECochG) in patients with Ménière's disease (MD). METHODS: Twenty-one patients with unilateral MD who underwent sac surgery were included in this study. All patients underwent gadolinium-enhanced magnetic resonance imaging (Gd-MRI) before and 2 years after sac surgery. We evaluated the difference in vestibular and cochlear endolymphatic hydrops between before and after surgery in both ears and compared these findings with the frequency of vertigo attacks, hearing level, and ECochG findings. RESULTS: In affected ears, the presence of vestibular endolymphatic hydrops and the frequency of vertigo attacks significantly decreased after surgery. However, affected ears showed no significant improvement in the presence of cochlear endolymphatic hydrops or the -SP/AP ratio by ECochG; there was also no significant improvement or deterioration in the hearing level. CONCLUSION: The present findings suggest that sac surgery reduces vestibular endolymphatic hydrops and prevents aggravation of cochlear endolymphatic hydrops, and these changes lead to a reduction of vertigo attacks and suppress the progression of hearing impairment associated with vertigo attacks.
OBJECTIVE: This study was performed to determine whether endolymphatic sac surgery improves vestibular and cochlear endolymphatic hydrops 2 years after sac surgery and to elucidate the relationship between the degree of improvement of endolymphatic hydrops and the changes in vertigo symptoms, the hearing level, and the summating potential/action potential ratio (-SP/AP ratio) by electrocochleography (ECochG) in patients with Ménière's disease (MD). METHODS: Twenty-one patients with unilateral MD who underwent sac surgery were included in this study. All patients underwent gadolinium-enhanced magnetic resonance imaging (Gd-MRI) before and 2 years after sac surgery. We evaluated the difference in vestibular and cochlear endolymphatic hydrops between before and after surgery in both ears and compared these findings with the frequency of vertigo attacks, hearing level, and ECochG findings. RESULTS: In affected ears, the presence of vestibular endolymphatic hydrops and the frequency of vertigo attacks significantly decreased after surgery. However, affected ears showed no significant improvement in the presence of cochlear endolymphatic hydrops or the -SP/AP ratio by ECochG; there was also no significant improvement or deterioration in the hearing level. CONCLUSION: The present findings suggest that sac surgery reduces vestibular endolymphatic hydrops and prevents aggravation of cochlear endolymphatic hydrops, and these changes lead to a reduction of vertigo attacks and suppress the progression of hearing impairment associated with vertigo attacks.