Surgical indication in Menie`re’s disease therapy: clinical and epidemiological aspects
- نوع فایل : کتاب
- زبان : انگلیسی
- مؤلف : Roberto Albera Andrea Canale Fiorella Parandero Alessandro Ducati Michele Lanotte
- چاپ و سال / کشور: 2011
Description
The aim of this study was to evaluate the frequency of surgical approach in a population of patients affected by definite Menie`re’s disease (MD). In the majority of patients, relief from vertigo attacks can be achieved by means of medical therapy (MT). In cases in which MT fails surgery may offer relief to vertigo. The most applied surgical procedures are intratympanic gentamicin (ITG) and vestibular neurectomy (VN), based on vestibular deafferentation. Until now, the real incidence of the different therapeutic approaches forMD has not been evaluated. The study design was a retrospective study. The study was performed in 177 patients affected by definite MD. Subjects referred directly for surgery by other centers were excluded from the study. All the patients were medically treated with salt restriction and diuretics. In case of MT failure, surgical therapy, ITG or retrosigmoid VN were proposed. In the 75% of cases, the only therapeutic approach was MT, while in 20%of cases we carried out ITG and in 5% VN. In 33% of VN group, this operation was carried out after ITG failure and in 67% as the first surgical approach. The VN group was characterized by younger age and higher disability degree. The primary therapy in definite MD seems to be MT. Ablative therapy represents the second choice: ITG was carried out in 80% of cases, while VN was performed in 20%.
Eur Arch Otorhinolaryngol (2011) 268:967–972, Received: 24 October 2010 / Accepted: 7 January 2011 / Published online: 19 January 2011 Springer-Verlag 2011
