Functional outcomes and caloric response changes after endolymphatic sac decompression

Am J Otolaryngol. 2024 Mar 20;45(4):104267. doi: 10.1016/j.amjoto.2024.104267. Online ahead of print.

Abstract

Objective: To evaluate caloric response changes after endolymphatic sac decompression (ESD), together with hearing outcomes and the functional benefit of the operation.

Methods: A retrospective chart review of subjects who underwent endolymphatic sac decompression at a tertiary referral centre was performed. Data on audiological results, caloric testing, and functional level scale of the patients were analysed.

Results: Twenty-eight patients who met our criteria were eligible for enrolment in the study. The average follow-up after surgery was 25 months (range, 13-41). Postoperative pure-tone threshold averages and reduced vestibular response values (RVR) were not significantly altered by ESD; whereas, functional level scores improved significantly.

Conclusion: Endolymphatic sac decompression is a surgical procedure that preserves hearing and vestibular function, and improves the daily functional level of patients with Ménière's disease. ESD can be preferred both in bilateral and unilateral disease because it does not alter vestibular function and preserves hearing.

Keywords: Caloric testing; Endolymphatic sac decompression; Endolymphatic sac surgery; Meniere disease; Vestibular testing.