Surgical treatment possibilities of drug-resistant Ménière‘s disease

Česká verzia

Authors: S. Brennerová ^1*; Z. Balatková ^1* ; R. Černý ²; V. Koucky ¹; V. Bandurová ¹; V. Svobodová ¹; M. Bonaventurová ⁴; M. Komarc ³; J. Plzák ¹; Z. Čada ¹
Authors place of work: Klinika otorinolaryngologie a chirurgie, hlavy a krku 1. LF UK a FN Motol, Praha ¹; Neurologická klinika, 2. LF UK a FN Motol, Praha ²; Ústav biofyziky a informatiky, 1. LF UK v Praze ³; Oddělení otorinolaryngologie, Fakultní Thomayerova nemocnice, v Praze ⁴
Published in the journal: Cesk Slov Neurol N 2021; 84/117(3): 263-268
Category: Original Paper
doi: https://doi.org/10.48095/cccsnn2021263

Summary

Aim: Ménière‘s disease is one of the most common paroxysmal disorders of the peripheral vestibular system. Treatment is mainly pharmacological. Treatment differs for acute attacks and the period between the attacks. If pharmacological treatment fails, chemical labyrinthectomy or surgical treatment is being used. The aim of this study was to determine the success of surgical treatment by comparing objective and subjective methods. Patients and methods: In a group of patients operated on for drug-resistant Ménière‘s disease, we evaluated the preoperative and postoperative results of the video-Head Impulse Test and caloric test with video oculographic recording. The Dizziness Handicap Inventory questionnaire was used for the subjective evaluation of symptoms. Results: Postoperatively, there is a statistically significant caloric hyporefl exia or areflexia in the operated ear (P < 0.05), while for the video-Head Impulse Test there was no significant difference observed in any of the monitored parameters before and after surgery (P > 0.05). After surgery, patients had a better quality of life from the perspective of dizziness according to the questionnaire survey. A significant difference in all evaluated parameters (P < 0.05) was observed. Conclusion: Using surgical treatment for Ménière‘s disease, it is possible to influence vestibular attacks with a significant improvement in the quality of life of patients. According to the results of the study, it seems to be useful to evaluate the postoperative condition by a combination of the caloric test and questionnaire methods.

Keywords:

Ménière‘s disease – chemical labyrintectomy – surgical labyrintectomy – neurectomy – video-Head Impulse Test – caloric test – Dizziness Handicap Inventory questionnaire

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