Meniere's disease and middle ear pressure - vestibular function after transtympanic tube placement

• Published in: Acta oto-laryngologica 2009-01, Vol.129 (12), p.1408-1413
• Main Authors: Park, Jonas Jae-Hyun, Chen, Yue-Shih, Westhofen, Martin
• Format: Article
• Language: English
• Subjects: Adult; Aged; Biological and medical sciences; cochlear aqueduct; Ear, auditive nerve, cochleovestibular tract, facial nerve: diseases, semeiology; Ear, Middle - physiopathology; Evoked Potentials; Female; Humans; Inner ear pressure; Male; Medical sciences; Meniere Disease - complications; Meniere Disease - physiopathology; Meniere Disease - surgery; Middle Aged; Middle Ear Ventilation; Non tumoral diseases; Otorhinolaryngology. Stomatology; Pressure; Retrospective Studies; round window membrane; sinusoidal harmonic acceleration testing; Vertigo - etiology; Vertigo - physiopathology; Vertigo - surgery; vestibular aqueduct; vestibular evoked myogenic potentials (VEMPs); Vestibular Function Tests
• ISSN: 0001-6489; 1651-2251
• DOI: 10.3109/00016480902791678

Conclusion: Selected patients with Meniere's disease (MD) show an improvement of disability from vertigo after transtympanic ventilation tube insertion, although an effect on vestibular function is not seen if ipsilateral middle ear pressure lower than -50 daPa is used as a selection criterion. Objectives: Transtympanic ventilation tube insertion as a treatment option for MD has been reported but its results have been controversial. So far, no investigations on vestibular function in patients with MD after tube insertion have been carried out. Subjects and methods: Twenty-two patients with unilateral MD who were intractable to medical treatment and who had an ipsilateral middle ear pressure lower than -50 daPa received a transtympanic ventilation tube. Vestibular evoked myogenic potentials (VEMPs) and sinusoidal harmonic acceleration (SHA) testing were recorded pre- and postoperatively and were compared. Results: Most patients (68.2%) reported an improvement of vertigo. Before surgery 63.6% of patients did not show VEMPs, whereas vestibulo-collic reflexes were measured in 36.4% of all cases compared with 68.2% of patients without and 31.8% with recorded VEMPs after surgery. No statistically different findings in gain and phase lag of SHA testing were seen postoperatively compared to preoperative findings.