Tenotomy of the middle ear muscles causes a dramatic reduction in vertigo attacks and improves audiological function in definite Meniere's disease

Acta Otolaryngol. 2012 May;132(5):491-7. doi: 10.3109/00016489.2011.642815. Epub 2011 Dec 27.

Abstract

Conclusions: Because the presented data reveal an immediate and persistent reduction of vertigo and a clear improvement in hearing function and functional scales, we conclude tenotomy to be effective in unilateral, definite Meniere's disease - laying the foundation for future prospective, randomized controlled trials.

Objectives: This study compares the unique long-term results of tenotomy of the stapedius and tensor tympani muscles in definite Meniere's disease refractory to medical treatment and presents a hypothesis on why tenotomy seems effective.

Methods: This was an interventional cohort study. The study sample comprised 30 patients (15 males, 15 females; average age 57 ± 13.1 years) with definite Meniere's disease (AAO-HNS criteria, 1995). Patients were evaluated pre- and postoperatively using pure tone audiometry, AAO-HNS questionnaires regarding vertigo attacks, functional level scores, and tinnitus, and were followed up for 2-9 years. Postoperative values were calculated for the patient collective as a whole and consequently divided into three equal postoperative terms of 3 years each.

Results: A statistically significant improvement of inner ear hearing levels postoperatively (p = 0.041) and a major reduction in vertigo attacks in all groups (p < 0.001) with complete absence of attacks in 26/30 patients was noted. Results remained constant up to 9 years postoperatively. Although tinnitus persisted, the intensity was lower overall (p = 0.013).

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Audiometry, Pure-Tone
  • Ear, Middle / surgery*
  • Female
  • Follow-Up Studies
  • Hearing / physiology*
  • Humans
  • Male
  • Meniere Disease / complications
  • Meniere Disease / physiopathology*
  • Meniere Disease / surgery
  • Middle Aged
  • Stapedius / surgery
  • Surveys and Questionnaires
  • Tenotomy / methods*
  • Tensor Tympani / physiopathology
  • Tensor Tympani / surgery*
  • Time Factors
  • Treatment Outcome
  • Vertigo / etiology
  • Vertigo / physiopathology
  • Vertigo / surgery*