Intervention Review

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Surgery for Ménière's disease

  1. Bas Pullens1,
  2. Hendrik P Verschuur2,
  3. Peter Paul van Benthem3,*

Editorial Group: Cochrane Ear, Nose and Throat Disorders Group

Published Online: 28 FEB 2013

Assessed as up-to-date: 7 NOV 2012

DOI: 10.1002/14651858.CD005395.pub3


How to Cite

Pullens B, Verschuur HP, van Benthem PP. Surgery for Ménière's disease. Cochrane Database of Systematic Reviews 2013, Issue 2. Art. No.: CD005395. DOI: 10.1002/14651858.CD005395.pub3.

Author Information

  1. 1

    University Medical Centre Utrecht, ENT Surgery, Utrecht, Netherlands

  2. 2

    Medical Center Haaglanden, Department of Otolaryngology, The Hague, Netherlands

  3. 3

    Gelre Ziekenhuizen, ENT Surgery, Apeldoorn, Netherlands

*Peter Paul van Benthem, ENT Surgery, Gelre Ziekenhuizen, Albert Schweitzerlaan 31, Apeldoorn, 7334 DZ, Netherlands. pvanbenthem@wxs.nl.

Publication History

  1. Publication Status: New search for studies and content updated (no change to conclusions)
  2. Published Online: 28 FEB 2013

SEARCH

 

Abstract

  1. Top of page
  2. Abstract
  3. Plain language summary

Background

This is an update of a Cochrane review first published in The Cochrane Library in Issue 1, 2010.

Ménière's disease is characterised by three major symptoms: vertigo, deafness, and tinnitus or aural fullness, all of which are discontinuous and variable in intensity. A number of surgical modalities, of varying levels of invasiveness, have been developed to reduce the symptoms of Ménière's disease, but it is not clear whether or not these are effective.

Objectives

To assess the effectiveness of surgical options for the treatment of Ménière's disease. All surgical interventions used in the treatment of Ménière's disease, either to alter the natural history of the disease or to abolish vestibular function, were considered for this review.

Search methods

We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ICTRP and additional sources for published and unpublished trials. The date of the most recent search was 7 November 2012.

Selection criteria

Randomised or quasi-randomised controlled studies of a surgical modality versus a placebo therapy in Ménière's disease.

Data collection and analysis

Two authors independently assessed trial quality and extracted data. We contacted study authors for further information.

Main results

The only surgical intervention which has been evaluated in randomised controlled trials and met the inclusion criteria was endolymphatic sac surgery. We identified two randomised trials, involving a total of 59 patients; one comparing endolymphatic sac surgery with ventilation tubes and one with simple mastoidectomy. Neither study reported any beneficial effect of surgery either in comparison to placebo surgery or grommet insertion.

Authors' conclusions

The two trials included in this review provide insufficient evidence of the beneficial effect of endolymphatic sac surgery in Ménière's disease.

 

Plain language summary

  1. Top of page
  2. Abstract
  3. Plain language summary

Surgery for Ménière's disease

Ménière's disease is characterised by recurrent attacks of three major symptoms: vertigo (rotational dizziness), deafness and tinnitus (ringing of the ears), and/or aural fullness, all of which are discontinuous and variable in intensity. The symptoms of Ménière's disease are thought to be caused by excess pressure in the fluids of the inner ear which leads to sudden attacks of vertigo and hearing loss. A number of surgical procedures, of varying levels of invasiveness, have been developed to reduce the symptoms of Ménière's disease, but it is not clear whether or not these are effective. The surgical interventions can be categorised as two types: one type of surgical intervention aims to affect the natural history of the disease, with conservation of vestibular function. The other type aims to relieve symptoms by abolishing vestibular function. Both types of surgical intervention are considered in this review. Despite an extensive search the review authors only found two randomised controlled trials studying surgical interventions for Ménière's disease. Both of these trials, involving a total of 59 patients, studied endolymphatic sac surgery; one comparing it to placebo surgery and the other to a different type of surgery. Neither trial detected a significant difference between the treatment and control group.