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 ENT 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

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Characteristics of included studies [ordered by study ID]
Bretlau 1989

MethodsRandomised, double-blind trial


ParticipantsPatients with Ménière's disease


InterventionsRegular mastoidectomy versus endolymphatic sac shunting


OutcomesVertigo
Hearing
Tinnitus/aural fullness


Notes9 years follow-up


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskThe method used to generate the allocation sequence was not described

Allocation concealment (selection bias)Unclear riskThe method used to conceal the allocation sequence was not described

Blinding (performance bias and detection bias)
All outcomes
Low riskThe patients underwent control examinations after surgery in another university than the university in which they were operated

Incomplete outcome data (attrition bias)
All outcomes
High riskNo intention-to-treat analysis

Selective reporting (reporting bias)Low riskThe investigator who reported outcomes was blinded to the intervention used

Follow-upLow riskBretlau 1989 has a 9-year follow-up

Certainty of diagnosisLow riskThere is no mention of the AAO-HNS criteria, but the inclusion criteria are identical

Thomsen 1998

MethodsRandomised, double-blind (until surgery)


ParticipantsPatients with Ménière's disease


InterventionsVentilation tubes versus endolymphatic sac shunting


OutcomesVertigo
Hearing
Tinnitus/aural fullness


Notes1-year follow-up


Risk of bias

BiasAuthors' judgementSupport for judgement

Random sequence generation (selection bias)Unclear riskThe method of randomisation was not described

Allocation concealment (selection bias)Low riskThe randomisation results were kept in sealed envelopes; these were opened just before start of the surgery

Blinding (performance bias and detection bias)
All outcomes
High riskNeither the patients, nor the surgeons, nor the investigators were blind to the intervention used

Incomplete outcome data (attrition bias)
All outcomes
Low riskThere were no losses to follow-up

Selective reporting (reporting bias)High riskThe investigators and patients were not blinded to the intervention used

Follow-upHigh riskFollow-up was 1 year

Certainty of diagnosisLow riskThe AAO-HNS criteria were used

 
Characteristics of excluded studies [ordered by study ID]

StudyReason for exclusion

Brinson 2007ALLOCATION:
No concealment of allocation

De La Cruz 2007ALLOCATION:
No concealment of allocation, no blinding, no randomisation

Durland 2005ALLOCATION:
No control group, therefore no concealment of allocation

Garduno-Anaya 2005ALLOCATION:
Patients were randomised into 2 groups. The sequence generation and concealment of allocation were not described.

PARTICIPANTS:
AAO-HNS criteria were used to diagnose Ménière's disease

INTERVENTION:
Intratympanic application of dexamethasone for the treatment of Ménière's disease, which is studied in a separate Cochrane review (Phillips 2011)

Heatley 1990ALLOCATION:
Non-randomised study

Rask-Andersen 2005ALLOCATION:
The sequence generation and allocation concealment were not described

PARTICIPANTS:
Patients with unilateral Ménière's disease. The AAO-HNS criteria were not used.

INTERVENTION:
Intratympanic application of latanoprost for the treatment of Ménière's disease will be studied in a separate Cochrane review

Silverstein 1998ALLOCATION:
Randomised

PARTICIPANTS:
Included patients with Ménière's disease and possible Ménière's disease

INTERVENTIONS:
Patients received 3 consecutive daily administrations of intratympanic dexamethasone or placebo. Intratympanic application of dexamethasone for the treatment of Ménière's disease is studied in a separate Cochrane review (Phillips 2011).

Teggi 2008ALLOCATION:
Randomised

PARTICIPANTS:
Patients with Ménière's disease according to the AAO-HNS criteria

INTERVENTION:
Low-level laser therapy (LLLT) versus betahistine. LLLT is not considered to be a surgical intervention