Functional Level and Dynamic Posturography Results Two Years after Vestibular Neurectomy in Patients with Severe Meniere’s Disease
Abstract
:1. Introduction
2. Materials and Methods
2.1. Ethical Consideration
2.2. Patient Description
2.3. Clinical Symptoms and Audiological Test Evaluation Protocol
2.4. Balance Evaluation Protocol
- (1)
- Somatosensory (SOM): the ratio of condition 2 to condition 1.
- (2)
- Visual (VIS): the ratio of condition 4 to condition 1.
- (3)
- Vestibular (VEST): the ratio of condition 5 to condition 1.
- (4)
- Visual preference (PREF): ratio of conditions with unreliable vision (3 + 6) to conditions with absent vision (2 + 5).
2.5. Surgical Treatment
2.6. Statistical Analysis
3. Results
3.1. Patients’ Characteristics
3.2. Preoperative Clinical Data
3.3. Preoperative Posturography Results
3.4. Correlation between Clinical Data and Preoperative Results
3.5. Postoperative Clinical Data
3.6. Postoperative Posturography Results
3.7. Correlation between Clinical Data and Postoperative Results
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Meniere, P. Sur une forme de surdité grave dépendant d’une lésion de l’oreille interne. Gaz. Med. Paris 1861, 16, 239–240. [Google Scholar]
- Gibson, W.P.R. Meniere’s Disease. Adv. Otorhinolaryngol. 2019, 82, 77–86. [Google Scholar] [CrossRef] [PubMed]
- Sajjadi, H.; Paparella, M.M. Meniere’s disease. Lancet 2008, 372, 406–414. [Google Scholar] [CrossRef] [PubMed]
- Paparella, M.M.; Djalilian, H.R. Etiology, pathophysiology of symptoms, and pathogenesis of Meniere’s disease. Otolaryngol. Clin. N. Am. 2002, 35, 529–545. [Google Scholar] [CrossRef] [PubMed]
- Gurkov, R.; Pyyko, I.; Zou, J.; Kentala, E. What is Meniere’s disease? A contemporary re-evaluation of endolymphatic hydrops. J. Neurol. 2016, 263 (Suppl. S1), S71–S81. [Google Scholar] [CrossRef] [PubMed]
- Zhang, Y.; Liu, B.; Wang, R.; Jia, R.; Gu, X. Characteristics of the Cochlear Symptoms and Functions in Meniere’s Disease. Chin. Med. J. 2016, 129, 2445–2450. [Google Scholar] [CrossRef] [PubMed]
- Jasinska-Nowacka, A.; Lachowska, M.; Niemczyk, K. Detailed clinical characteristics and its correlation with the diagnostic test results in patients with defined Ménière’s disease. Otolaryngol. Pol. 2023, 77, 23–31. [Google Scholar] [CrossRef] [PubMed]
- Committee on Hearing and Equilibrium. Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Meniere’s disease. Otolaryngol. Head Neck Surg. 1995, 113, 181–185. [Google Scholar] [CrossRef]
- Lopez-Escamez, J.A.; Carey, J.; Chung, W.-H.; Goebel, J.A.; Magnusson, M.; Mandalà, M.; Newman-Toker, D.E.; Strupp, M.; Suzuki, M.; Trabalzini, F.; et al. Diagnostic criteria for Meniere’s disease. Consensus document of the Barany Society, the Japan Society for Equilibrium Research, the European Academy of Otology and Neurotology (EAONO), the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and the Korean Balance Society. Acta Otorrinolaringol. Esp. 2016, 67, 1–7. [Google Scholar] [CrossRef]
- Basura, G.J.; Adams, M.E.; Monfared, A.; Schwartz, S.R.; Antonelli, P.J.; Burkard, R.; Bush, M.L.; Bykowski, J.; Colandrea, M.; Derebery, J.; et al. Clinical Practice Guideline: Meniere’s Disease. Otolaryngol. Head Neck Surg. 2020, 162 (Suppl. S2), S1–S55. [Google Scholar] [CrossRef]
- Nevoux, J.; Barbara, M.; Dornhoffer, J.; Gibson, W.; Kitahara, T.; Darrouzet, V. International consensus (ICON) on treatment of Meniere’s disease. Eur. Ann. Otorhinolaryngol. Head Neck Dis. 2018, 135, S29–S32. [Google Scholar] [CrossRef] [PubMed]
- Nevoux, J.; Franco-Vidal, V.; Bouccara, D.; Parietti-Winkler, C.; Uziel, A.; Chays, A.; Dubernard, X.; Couloigner, V.; Darrouzet, V.; Mom, T.; et al. Diagnostic and therapeutic strategy in Meniere’s disease. Guidelines of the French Otorhinolaryngology-Head and Neck Surgery Society (SFORL). Eur. Ann. Otorhinolaryngol. Head Neck Dis. 2017, 134, 441–444. [Google Scholar] [CrossRef] [PubMed]
- Magnan, J.; Özgirgin, O.N.; Trabalzini, F.; Lacour, M.; Escamez, A.L.; Magnusson, M.; Güneri, E.A.; Guyot, J.P.; Nuti, D.; Mandalà, M. European Position Statement on Diagnosis, and Treatment of Meniere’s Disease. J. Int. Adv. Otol. 2018, 14, 317–321. [Google Scholar] [CrossRef] [PubMed]
- Quaranta, N.; Picciotti, P.; Porro, G.; Sterlicchio, B.; Danesi, G.; Petrone, P.; Asprella Libonati, G. Therapeutic strategies in the treatment of Meniere’s disease: The Italian experience. Eur. Arch. Oto-Rhino-Laryngol. 2019, 276, 1943–1950. [Google Scholar] [CrossRef] [PubMed]
- Niemczyk, K.; Jasińska, A.; Pierchała, K. Ménière’s disease pt. 2. Treatment options and therapeutic strategies. Commentary to the current recommendations and own experience. Pol. Otorhinolaryngol. Rev. 2020, 9, 18–22. [Google Scholar] [CrossRef]
- Lahiji, M.R.; Akbarpour, M.; Soleimani, R.; Asli, R.H.; Leyli, E.K.; Saberi, A.; Akbari, M.; Ramezani, H.; Nemati, S. Prevalence of anxiety and depression in Meniere’s disease; a comparative analytical study. Am. J. Otolaryngol. 2022, 43, 103565. [Google Scholar] [CrossRef] [PubMed]
- Patel, J.J.; Levy, D.A.; Nguyen, S.A.; Rizk, H.G.; Meyer, T.A. Depression in Meniere’s disease: A systematic review and meta-analysis. J. Laryngol. Otol. 2020, 134, 293–301. [Google Scholar] [CrossRef] [PubMed]
- Bell, S.L.; Tyrrell, J.; Phoenix, C. A day in the life of a Meniere’s patient: Understanding the lived experiences and mental health impacts of Meniere’s disease. Sociol. Health Illn. 2017, 39, 680–695. [Google Scholar] [CrossRef] [PubMed]
- Tyrrell, J.; White, M.P.; Barrett, G.; Ronan, N.; Phoenix, C.; Whinney, D.J.; Osborne, N.J. Mental Health and Subjective Well-being of Individuals With Meniere’s: Cross-sectional Analysis in the UK Biobank. Otol. Neurotol. 2015, 36, 854–861. [Google Scholar] [CrossRef]
- Soderman, A.C.; Bergenius, J.; Bagger-Sjoback, D.; Tjell, C.; Langius, A. Patients’ subjective evaluations of quality of life related to disease-specific symptoms, sense of coherence, and treatment in Meniere’s disease. Otol. Neurotol. 2001, 22, 526–533. [Google Scholar] [CrossRef]
- Arenberg, I.K.; Stahle, J. Staging Meniere’s disease (or any inner ear dysfunction) and the use of the vertigogram. Otolaryngol. Clin. N. Am. 1980, 13, 643–656. [Google Scholar] [CrossRef]
- Pappas, D.G., Jr.; Pappas, D.G., Sr. Vestibular nerve section: Long-term follow-up. Laryngoscope 1997, 107, 1203–1209. [Google Scholar] [CrossRef] [PubMed]
- Jacobson, G.P.; Newman, C.W. The development of the Dizziness Handicap Inventory. Arch. Otolaryngol. Head Neck Surg. 1990, 116, 424–427. [Google Scholar] [CrossRef] [PubMed]
- Szostek-Rogula, S.; Zamyslowska-Szmytke, E. Validation of the Polish version of the Dizziness Handicap Inventory. Med. Pracy 2019, 70, 529–534. [Google Scholar] [CrossRef] [PubMed]
- Rizk, H.G.; Velozo, C.; Shah, S.; Hum, M.; Sharon, J.D.; McRackan, T.R. Item Level Psychometrics of the Dizziness Handicap Inventory in Vestibular Migraine and Meniere’s Disease. Ear Hear. 2024, 45, 106–114. [Google Scholar] [CrossRef] [PubMed]
- Garcia-Ibanez, E.; Garcia-Ibanez, J.L. Middle fossa vestibular neurectomy: A report of 373 cases. Otolaryngol. Head Neck Surg. 1980, 88, 486–490. [Google Scholar] [CrossRef] [PubMed]
- Leveque, M.; Seidermann, L.; Tran, H.; Langagne, T.; Ulmer, E.; Chays, A. Vestibular function outcomes after vestibular neurectomy in Meniere disease: Can vestibular neurectomy provide complete vestibular deafferentation? Auris Nasus Larynx 2010, 37, 308–313. [Google Scholar] [CrossRef] [PubMed]
- Lemnos, L.; Aubry, K.; Moreau, J.J.; Caire, F.; Salle, H. Postoperative compensation after neurotomy in Meniere’s disease: Retrospective study of 15 cases. Neurochirurgie 2019, 65, 20–26. [Google Scholar] [CrossRef]
- Silverstein, H.; Wanamaker, H.; Flanzer, J.; Rosenberg, S. Vestibular neurectomy in the United States—1990. Am. J. Otol. 1992, 13, 23–30. [Google Scholar] [CrossRef]
- Schlegel, M.; Vibert, D.; Ott, S.R.; Hausler, R.; Caversaccio, M.D. Functional results and quality of life after retrosigmoid vestibular neurectomy in patients with Meniere’s disease. Otol. Neurotol. 2012, 33, 1380–1385. [Google Scholar] [CrossRef]
- Tewary, A.K.; Riley, N.; Kerr, A.G. Long-term results of vestibular nerve section. J. Laryngol. Otol. 1998, 112, 1150–1153. [Google Scholar] [CrossRef] [PubMed]
- Thomsen, J.; Berner, B.; Tos, M. Vestibular neurectomy. Auris Nasus Larynx 2000, 27, 297–301. [Google Scholar] [CrossRef] [PubMed]
- Véleine, Y.; Brenet, E.; Labrousse, M.; Chays, A.; Bazin, A.; Kleiber, J.C.; Dubernard, X. Long-term efficacy of vestibular neurotomy in disabling Meniere’s disease and Tumarkin drop attacks. J. Neurosurg. 2022, 137, 1034–1040. [Google Scholar] [CrossRef] [PubMed]
- Jasinska-Nowacka, A.; Lachowska, M.; Wnuk, E.; Niemczyk, K. Changes in endolymphatic hydrops after vestibular neurectomy observed in magnetic resonance imaging—A pilot study. Auris Nasus Larynx 2022, 49, 584–592. [Google Scholar] [CrossRef] [PubMed]
- Reid, C.B.; Eisenberg, R.; Halmagyi, G.M.; Fagan, P.A. The outcome of vestibular nerve section for intractable vertigo: The patient’s point of view. Laryngoscope 1996, 106 Pt 1, 1553–1556. [Google Scholar] [CrossRef] [PubMed]
- Takeda, N.; Matsuda, K.; Fukuda, J.; Sato, G.; Uno, A.; Kitahara, T. Vestibular compensation: Neural mechanisms and clinical implications for the treatment of vertigo. Auris Nasus Larynx. 2023, 51, 328–336. [Google Scholar] [CrossRef]
- Esteban-Sanchez, J.; Martin-Sanz, E. Long-Term Evolution of Vestibular Compensation, Postural Control, and Perceived Disability in a Population of Patients with Vestibular Neuritis. J. Clin. Med. 2022, 11, 3941. [Google Scholar] [CrossRef]
- Cass, S.P.; Goshgarian, H.G. Vestibular compensation after labyrinthectomy and vestibular neurectomy in cats. Otolaryngol. Head Neck Surg. 1991, 104, 14–19. [Google Scholar] [CrossRef] [PubMed]
- Vibert, D.; Allum, J.H.; Kompis, M.; Wiedmer, S.; Stieger, C.; Häusler, R.; Caversaccio, M. Measurements of Trunk Sway for Stance and Gait Tasks 2 Years after Vestibular Neurectomy. Audiol. Neurootol. 2018, 23, 298–308. [Google Scholar] [CrossRef]
- Soto, A.; Labella, T.; Santos, S.; Del Rio, M.; Lirola, A.; Cabanas, E.; Elhendi, W. The usefulness of computerized dynamic posturography for the study of equilibrium in patients with Meniere’s disease: Correlation with clinical and audiologic data. Hear. Res. 2004, 196, 26–32. [Google Scholar] [CrossRef]
- Miyazaki, H.; Nomura, Y.; Mardassi, A.; Deveze, A.; Miura, M.; Jike, M.; Magnan, J. How minimally invasive vestibular neurotomy for incapacitating Meniere’s disease improves dizziness and anxiety. Acta Otolaryngol. 2017, 137, 707–711. [Google Scholar] [CrossRef] [PubMed]
- Parietti-Winkler, C.; Gauchard, G.C.; Simon, C.; Perrin, P.P. Long-term effects of vestibular compensation on balance control and sensory organisation after unilateral deafferentation due to vestibular schwannoma surgery. J. Neurol. Neurosurg. Psychiatry 2010, 81, 934–936. [Google Scholar] [CrossRef] [PubMed]
- Parietti-Winkler, C.; Gauchard, G.C.; Simon, C.; Perrin, P.P. Pre-operative vestibular pattern and balance compensation after vestibular schwannoma surgery. Neuroscience 2011, 172, 285–292. [Google Scholar] [CrossRef]
- Yip, C.W.; Strupp, M. The Dizziness Handicap Inventory does not correlate with vestibular function tests: A prospective study. J. Neurol. 2018, 265, 1210–1218. [Google Scholar] [CrossRef] [PubMed]
Grade | Patient’s Subjective Description |
---|---|
1 | My dizziness has no effect on my activities at all |
2 | When I am dizzy I have to stop what I am doing for a while, but it soon passes and I can resume activities, I continue to work, drive, and engage in any activity I choose without restriction; I have not changed any plans or activities to accommodate my dizziness |
3 | When I am dizzy I have to stop what I am doing for a while, but it does pass and I can resume activities; I continue to work, drive, and engage in most activities I choose, but I have had to change some plans and make some allowance for my dizziness |
4 | I am able to work, drive, travel, take care of a family, or engage in most essential activities, but I must exert a great deal of effort to do so; I must constantly make adjustments in my activities and budget my energies; I am barely making it |
5 | I am unable to work, drive or take care of a family; I am unable to do most of the active things that I used to; even essential activities must be limited; I am disabled |
6 | I have been disabled for 1 year or longer and/or I receive compensation (money) because of my dizziness or balance |
P1. Does looking up increase your problem? |
E2. Because of your problem, do you feel frustrated? |
F3. Because of your problem, do you restrict your travel for business or recreation? |
P4. Does walking down the aisle of a supermarket increase your problems? |
F5. Because of your problem, do you have difficulty getting into or out of bed? |
F6. Does your problem significantly restrict your participation in social activities, such as going out to dinner, going to the movies, dancing, or going to parties? |
F7. Because of your problem, do you have difficulty reading? |
P8. Does performing more ambitious activities such as sports, dancing, household chores (sweeping or putting dishes away) increase your problems? |
E9. Because of your problem, are you afraid to leave your home without having someone accompany you? |
E10. Because of your problem have you been embarrassed in front of others? |
P11. Do quick movements of your head increase your problem? |
F12. Because of your problem, do you avoid heights? |
P13. Does turning over in bed increase your problem? |
F14. Because of your problem, is it difficult for you to do strenuous homework or yard work? |
E15. Because of your problem, are you afraid people may think you are intoxicated? |
F16. Because of your problem, is it difficult for you to go for a walk by yourself? |
P17. Does walking down a sidewalk increase your problem? |
E18. Because of your problem, is it difficult for you to concentrate? |
F19. Because of your problem, is it difficult for you to walk around your house in the dark? |
E20. Because of your problem, are you afraid to stay home alone? |
E21. Because of your problem, do you feel handicapped? |
E22. Has the problem placed stress on your relationships with members of your family or friends? |
E23. Because of your problem, are you depressed? |
F24. Does your problem interfere with your job or household responsibilities? |
P25. Does bending over increase your problem? |
Before Surgery | |||||
Patient’s Characteristics | Mean | Min | Max | SD | |
Age (years) | 50.60 | 34.00 | 65.00 | 11.60 | |
MD duration (years) | 6.93 | 1.00 | 18.00 | 4.68 | |
Average number of vertigo episodes within the last 6 months (per month) | 2.93 | 0.00 | 11.66 | 2.86 | |
Balance problems | Average severity within the last 6 months (0–6 Arenberg scale) | 3.07 | 0.00 | 5.50 | 1.27 |
Tinnitus | 4.36 | 2.00 | 6.00 | 1.12 | |
Aural fullness | 3.02 | 0.00 | 6.00 | 1.71 | |
Functional level (1–6 AAO-HNS scale) | 4.50 | 3.00 | 6.00 | 0.83 | |
DHI total score (0–100 points) | 81.70 | 42.00 | 100.00 | 13.30 | |
PTA level (dB HL) | 53.00 | 17.50 | 78.75 | 17.95 | |
After Surgery | |||||
Patient’s Characteristics | Mean | Min | Max | SD | |
Follow-up interval (months) | 25.11 | 18.00 | 35.00 | 3.88 | |
Average number of vertigo episodes within the last 6 months (per month) | 0.00 (−2.93) * | 0.00 | 0.00 | 0.00 | |
Balance problems | Average severity within the last 6 months (0–6 Arenberg scale) | 1.55 (−1.52) * | 0.00 | 4.00 | 1.33 |
Tinnitus | 3.48 (−0.88) * | 0.00 | 6.00 | 1.67 | |
Aural fullness | 1.12 (−1.90) * | 0.00 | 5.50 | 1.47 | |
Functional level (1–6 AAO-HNS scale) | 1.60 (−2.90) * | 1.00 | 4.00 | 0.82 | |
DHI total score (0–100 points) | 16.40 (−6.53) * | 0.00 | 52.00 | 12.97 | |
PTA level (dB HL) | 70.00 (+17.00) * | 41.25 | 120.00 | 22.41 |
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Jasińska-Nowacka, A.; Lachowska, M.; Niemczyk, K. Functional Level and Dynamic Posturography Results Two Years after Vestibular Neurectomy in Patients with Severe Meniere’s Disease. J. Clin. Med. 2024, 13, 3362. https://doi.org/10.3390/jcm13123362
Jasińska-Nowacka A, Lachowska M, Niemczyk K. Functional Level and Dynamic Posturography Results Two Years after Vestibular Neurectomy in Patients with Severe Meniere’s Disease. Journal of Clinical Medicine. 2024; 13(12):3362. https://doi.org/10.3390/jcm13123362
Chicago/Turabian StyleJasińska-Nowacka, Agnieszka, Magdalena Lachowska, and Kazimierz Niemczyk. 2024. "Functional Level and Dynamic Posturography Results Two Years after Vestibular Neurectomy in Patients with Severe Meniere’s Disease" Journal of Clinical Medicine 13, no. 12: 3362. https://doi.org/10.3390/jcm13123362