Systematic literature review and meta-analysis for the evaluation of endolymphatic shunt surgery in patients with Menière's disease

IntroductionIn case of insufficient conservative treatment of the Menière's disease, surgical intervention in the form of endolymphatic sac shunting may be considered. This study provides a systematic literature review and meta-analysis in order to evaluate the treatment efficiency of this functional preservative intervention in patients with Menière's disease.

Methods The general approach of this systematic evaluation was based on the guidelines of the Cochrane Collaboration and the PRISMA protocol. The literature review was conducted in the databases PubMed, Embase and Central for studies published from 1985 to 2019. The main inclusion criteria were the classification categories according to the AAO-HNS guidelines of 1985 and 1995 and the quality of the reported data. Data extraction covered the outcomes PTA audiometry, speech discrimination, vertigo control and functional level scale. In the course of the meta-analysis the weighted mean were determined for those endpoints.

Results Within the literature review, out of 459 hits, 14 relevant studies could be identified. In total, these 14 studies cover all evaluation outcomes. In the context of limited data quality and availability, the statements of the meta-analysis shall be considered in relative terms. The meta-analysis shows an improvement in functional level scale, as well as a reduction of vertigo. The observed outcome of PTA audiometry is classified as "clinically not significant" according to AAO-HNS 85/95, in contrast, the deterioration of speech discrimination is classified as "clinically significant".

ConclusionAccording to the meta-analysis, the ELS is classified as effective for the treatment of Menière's disease and does not influence the natural course of hearing in the PTA audiometry significantly.

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Publication History

Article published online:
10 June 2020