Endolymphatic Duct Blockage Effective in Treating Meniere's disease: Study

A recent study highlighted compared the effectiveness Endolymphatic Duct Blockage (EDB) and Intratympanic Methylprednisolone (ITMP) injections, which is helpful in treating refractory Ménière’s disease (MD). This research published in the recent issue of European Archives of Oto-Rhino-Laryngology with a focus on the impact of these therapies on vertigo control and hearing levels.

The retrospective study included 88 patients with refractory MD and divided them into two groups, where one group of 36 patients received ITMP injections, while the other group of 52 patients underwent EDB surgery. The primary outcomes like vertigo control, tinnitus, aural fullness and hearing levels were measured 24 months following treatment. Hearing levels were assessed using pure-tone average (PTA), bone conduction average (BCA) and speech discrimination score (SDS).

These findings revealed a significant difference in the effectiveness of the two treatments in controlling vertigo. At the marl of 24 months following the treatment, 90.4% of patients in the EDB group reported complete control of vertigo symptoms when compared to only 43.4% in the ITMP group. This difference highlight the superior efficacy of EDB in managing vertigo.

Tinnitus and aural fullness showed improvements in both treatments, but, there was no significant difference between these groups. The EDB group expressed a notable reduction in the frequency of tinnitus and aural fullness, with p-values of 0.03 and less than 0.001, respectively. The ITMP group also faced a significant decrease in tinnitus (p=0.03), but the improvement in aural fullness was not statistically significant (p=0.063).

When concerning the hearing levels, the EDB group demonstrated better outcomes. The ITMP group showed a significant worsening in PTA, BCA and SDS when compared to preoperative levels. Also, the EDB group maintained stable hearing levels, with no significant difference in PTA than the ITMP group (p=0.48). However, BCA and SDS were significantly better in the EDB group.

The findings of this study found that EDB is more effective than ITMP in controlling vertigo symptoms in patients with Ménière’s disease while also preserving hearing function. EDB was a novel surgical technique with effective results that offer a more comprehensive treatment option for this condition. Overall, these findings unveil the role of EDB as a potential surgical intervention for MD for patients seeking better management of their symptoms and preservation of their hearing.

Reference:

Saliba, I., Dufour-Fournier, C., & Asmar, M.-H. (2024). Endolymphatic duct blockage surgery vs. intratympanic steroids for treatment of refractory Ménière’s disease. In European Archives of Oto-Rhino-Laryngology. Springer Science and Business Media LLC. https://doi.org/10.1007/s00405-024-08736-4