Tenotomy of the middle ear muscles causes a dramatic reduction in vertigo attacks and improves audiological function in definite Meniere's disease.

Abstract

CONCLUSIONS:

Because the presented data reveal an immediate and persistent reduction of vertigo and a clear improvement in hearing function and functional scales, we conclude tenotomy to be effective in unilateral, definite Meniere's disease - laying the foundation for future prospective, randomized controlled trials.

OBJECTIVES:

This study compares the unique long-term results of tenotomy of the stapedius and tensor tympani muscles in definite Meniere's disease refractory to medical treatment and presents a hypothesis on why tenotomy seems effective.

METHODS:

This was an interventional cohort study. The study sample comprised 30 patients (15 males, 15 females; average age 57 ± 13.1 years) with definite Meniere's disease (AAO-HNS criteria, 1995). Patients were evaluated pre- and postoperatively using pure tone audiometry, AAO-HNS questionnaires regarding vertigo attacks, functional level scores, and tinnitus, and were followed up for 2-9 years. Postoperative values were calculated for the patient collective as a whole and consequently divided into three equal postoperative terms of 3 years each.

RESULTS:

A statistically significant improvement of inner ear hearing levels postoperatively (p = 0.041) and a major reduction in vertigo attacks in all groups (p < 0.001) with complete absence of attacks in 26/30 patients was noted. Results remained constant up to 9 years postoperatively. Although tinnitus persisted, the intensity was lower overall (p = 0.013).

• Authors: Benjamin Loader, David Beicht, Jafar-Sasan Hamzavi, Peter Franz
• Journal: Acta oto-laryngologica (Acta Otolaryngol) Vol. 132 Issue 5 Pg. 491-7 (May 2012) ISSN: 1651-2251 [Electronic] England
• PMID: 22201453 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Topics

• Audiometry, Pure-Tone
• Ear, Middle (surgery)
• Female
• Follow-Up Studies
• Hearing (physiology)
• Humans
• Male
• Meniere Disease (complications, physiopathology, surgery)
• Middle Aged
• Stapedius (surgery)
• Surveys and Questionnaires
• Tenotomy (methods)
• Tensor Tympani (physiopathology, surgery)
• Time Factors
• Treatment Outcome
• Vertigo (etiology, physiopathology, surgery)