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William Durland ‘03Durland WF, Pyle GM, Connor NP. Endolymphatic sac decompression as a treatment for Meniere's Disease. Laryngoscope, 2005, 115: 1454-1457.Objectives: Endolymphatic sac decompression (ELSD) is a surgical treatment option for patients with medically intractable Meniere’s disease. Effectiveness, however, is debated because published data show great variability. Outcomes-based research studies are useful in incorporating the patient’s perspective on the success of treatment. To further assess effectiveness of ELSD, we performed a prospective study to examine both symptom-specific outcomes and general health outcomes. Study Design: Prospective, observational, outcome study. Methods: Nineteen patients with ELSD responded to symptom-specific questionnaires and the Medical Outcomes Trust Short Form 36 Health Survey (SF-36) pre- and post-surgery. Follow-up ranged from 6 months to 58 months with a mean of 50 months. Results: Overall measures of physical health were significantly improved following ELSD (p=0.04), while overall measures of mental health were unchanged (p=0.74). Role Physical and Social Functioning scores were significantly improved following ELSD (p=0.04 and p=0.03, respectively). Study patients scored significantly lower (p<0.05) than SF-36 normative data in 6 of 10 categories prior to ELSD, but were not significantly different from normal scores in all but 1 category (General Health) following ELSD. The mean number of vertigo episodes was significantly reduced from an average of 8.3 times per month to an average of 2.6 times per month following ELSD (p=0.006). Ninety-five percent (18/19) of patients reported improvement in symptoms (frequency, duration, or intensity) of vertigo and 37% (7/19) reported complete resolution of vertigo. Conclusions: ELSD significantly improved perception of physical health as well as symptom-specific outcomes in patients with medically intractable Meniere’s disease. Keywords: Endolymphatic sac decompression, Meniere’s
disease, quality of life, vertigo
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