Effect of transtympanic ventilation tube insertion for patients with intractable Meniere’s disease

Authors

  • Tessei Kuruma Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, Yazakokarimata, Nagakute-Shi, Aichi, Japan http://orcid.org/0000-0001-8797-223X
  • Mariko Arimoto Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, Yazakokarimata, Nagakute-Shi, Aichi, Japan
  • Mayuko Kishimoto Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, Yazakokarimata, Nagakute-Shi, Aichi, Japan
  • Yasue Uchida Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, Yazakokarimata, Nagakute-Shi, Aichi, Japan
  • Tetsuya Ogawa Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, Yazakokarimata, Nagakute-Shi, Aichi, Japan
  • Yasushi Fujimoto Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, Yazakokarimata, Nagakute-Shi, Aichi, Japan

DOI:

https://doi.org/10.18203/issn.2454-5929.ijohns20213273

Keywords:

Meniere’s disease, Ventilation tube, Vertigo, Endolymphatic hydrops, Eustachian tube

Abstract

Background: This study aimed to clarify the effects of transtympanic tube insertion on patients with Meniere’s disease refractory to conservative treatment.

Methods: Between January 2010 and December 2019, 40 patients with refractory Meniere’s disease were assigned to group I, a group of 19 patients who underwent transtympanic tube insertion (13 males, 6 females; age range 15-79 years) and group II, a control group of 21 patients who did not undergo intratympanic tube insertion (10 males, 11 females; age range 26-81 years). Definitive vertigo spells, hearing level, tinnitus and aural fullness were assessed for 2 years after treatment. The effectiveness of treatment for vertigo attacks and hearing loss was assessed according to the 1995 American academy of otolaryngology-head and neck surgery criteria. The degree of disability due to vertiginous attacks was also assessed and compared between groups using the dizziness handicap inventory (DHI) before and 2 years after treatment.

Results: The frequency of vertigo attacks and the DHI score were significantly better in group I than in group II 2 years after treatment. Group I also showed significantly improved tinnitus and feelings of fullness. However, the hearing level remained unaffected in both groups.

Conclusions: This less invasive treatment might offer short term efficacy in reducing persistent vertigo, tinnitus and a feeling of aural fullness for some patients with Meniere’s disease. 

Author Biography

Tessei Kuruma, Department of Otorhinolaryngology, Head and Neck Surgery, Aichi Medical University, Yazakokarimata, Nagakute-Shi, Aichi, Japan

Department of Otorhinolaryngology, Head and Neck Surgery MD-Ph.D Senior lecturer

References

Liu F, Huang W, Chen Q, Meng X, Wang Z, He Y. Noninvasive evaluation of the effect of endolymphatic sac decompression in Ménière’s disease using magnetic resonance imaging. Acta Otolaryngol. 2014;134(7):666-71.

Hallpike S, Cairns H. Observations on the pathology of Meniere’s syndrome. J Laryngol Otol. 1938;53(10):625-55.

Committee on Hearing and Equilibrium. Committee on Hearing and Equilibrium Guidelines for the Diagnosis and Evaluation of Therapy in Ménière’s Disease. Otolaryngol Head Neck Surg. 1995;113(3):181-5.

Turmarkin A. Thoughts on the treatment of labyrinthopathy. J Laryngol Otol. 1966;80(10):1041-53.

Lall M. Meniere’s disease and the grommet (a survey of its therapeutic effects). J Laryngol Otol. 1969;83(8):787-91.

Schuknecht HF. Pathophysiology of Meniere’s disease. Otolaryngol Clin North Am. 1975;8(2):507-14.

Palva T, Martila T, Jauhiaien T. Comparison of pure tones and noise stimuli in sonotubometry. Acta Otolaryngol. 1987;103(5-6):212-6.

Cinnamond MJ. Eustachian tube function in Menière’s disease. J Laryngol Otol. 1975;89(1):57-61.

Hall M, Brackmann DE. Eustachian tube blockage and Meniere’s disease. Arch Otolaryngol. 1977;103(6):355-7.

Montandon P, Guillemin P, Häusler R. Prevention of vertigo in Ménière's syndrome by means of transtympanic ventilation tubes. ORL J Otorhinolaryngol Relat Spec. 1988;50(6):377-81.

Thomsen J, Bonding P, Becker B, Stage J, Tos M. The non-specific effect of endolymphatic sac surgery treatment of Ménière's disease: a prospective, randomized controlled study comparing "classic" endolymphatic sac surgery with the insertion of a ventilating tube in the tympanic membrane. Acta Otolaryngol. 1998;118(6):769-73.

Sugawara K, Kitamura K, Ishida T, Sejima T. Insertion of tympanic ventilation tubes as a treating modality for patients with Meniere's disease: a short- and long-term follow-up study in seven cases. Auris Nasus Larynx. 2003;30(1):25-8.

Park JJ, Chen YS, Westhofen M. Meniere's disease and middle ear pressure: vestibular function after transtympanic tube placement. Acta Otolaryngol. 2009;129(12):1408-13.

Densert B, Densert O, Arlinger S, Sass K, Odkvist L. Immediate effects of middle ear pressure changes on the electrocochleographic recordings in patients with Menière’s disease: a clinical placebo-controlled study. Am J Otol. 1997;18(6):726-33.

Ingelstedt S, Ivarsson A, Tjernström O. Vertigo due to relative overpressure in the middle ear. an experimental study in man. Acta Otolaryngol. 1974;78(1-2):1-14.

Kimura RS, Hutta J. Inhibition of experimentally induced endolymphatic hydrops by middle ear ventilation. Eur Arch Otorhinolaryngol. 1997;254(5):213-8.

Ogi K, Manabe Y, Yamada T, Takabayashi T, Kimura Y, Narita N, et al. Meniere’s disease with patulous eustachian tubes. J Neurol Neurosci. 2015;6:28

Ingelstedt S, Jonson B, Rundcrantz H. Gas tension and pH in middle ear effusion. Ann Otol Rhinol Laryngol. 1975;84:198-202.

Yoshida M, Lowry LD. Hydrostatic pressure measurement of endolymph in the guinea pig cochlea. Am J Otolaryngol. 1984;5(3):159-65.

Ikeda K, Kusakari J, Takasaka T, Saito Y. The Ca2+ activity of cochlear endolymph of the guinea pig and the effect of inhibitors. Hear Res. 1987;26(1):117-25.

Furuta H, Mori N, Hoshikawa H, Sakai S, Iwakura S, Doi K. Detection of hormone receptors in the rat cochlea using molecular biological techniques. Proc Sendai Symp. 1994;4:43-5.

Robinson PJ, Hazell JW. Patulous eustachian tube syndrome: the relationship with sensorineural hearing loss. treatment by eustachian tube diathermy. J Laryngol Otol. 1989;103(8):739-42.

Heermann J. Predominance of left ear in Meniére’s disease, sudden deafness, inner ear damage, tinnitus and abnormally patent eustachian tube. Ear Nose Throat J. 1993;72(3):205-8.

Gottesberg AMZ, Lamprecht J. Localization of the atrial natriuretic peptide binding sites in the inner ear tissue-possibly an additional regulating system. Acta Otolaryngol Suppl. 1989;468:53-7.

Heermann J. Unilateral patulous eustachian tube with tinnitus, inner ear damage, vertigo and sudden deafness-collagen injection. HNO. 1988;36(1):13-5.

Ogawa Y, Otsuka K, Hagiwara A, Inagaki A, Shimizu S, Nagai N, et al. Clinical study of tympanostomy tube placement for patients with intractable Ménière’s disease. J Laryngol Otol. 2015;129(2):120-5.

Levo H, Kentala E, Rasku J, Pyykkö I. Aural fullness in Ménière’s disease. Audiol Neurootol. 2014;19(6):395-9.

Yoshida T, Stephens D, Kentala E, Levo H, Auramo Y, Poe D, et al. Tinnitus complaint behaviour in long-standing Menière’s disorder: its association with the other cardinal symptoms. Clin Otolaryngol. 2011;36(5):461-7.

Downloads

Published

2021-08-23

Issue

Section

Original Research Articles