Various approaches in semicircular canal plugging for treatment of intractable Meniere's disease

Zhang Daogong; Fan zhaomin; Han Yuechen; Xu lei; Lv Yafeng; Li Yawei; Wang Haibo

doi:10.3969/j.issn.1672-2922.2016.04.002

Abstract：Objective To report vertigo and hearing outcomes following various approaches in semicircular canal plug-ging in treating intractable Meniere’s disease. Methods Data from 328 patients with Meniere’s disease treated by authors from December 2010 to January 2016 were reviewed. Unilateral Meniere’s disease was diagnosed in all patients according to the Standards of Diagnosis and Outcomes Assessment (Guiyang, 2006). All patients had received regular conservative treatment for at least one year, with continuing recurrent vertigo attacks. Plugging was performed in 3 semicircular canals in 302 cases, in 2 canals in 21 cases (horizontal-posterior canal plugging, n=15;horizontal-superior canal plugging, n=6) and in 1 canal in 5 cases (all horizontal canals). Pure tone audiometry, caloric tests and cervical vestibular evoked myogenic potential (VEMP) were used for hearing and vestibular assessment. MRI membranous labyrinth imaging was used to ob-serve membranous labyrinth morphology changes following plugging treatment. Results Total rate of vertigo control was 98.0%(296/302) for three canal plugging [class A 81.8%(247/302), class B 16.2%(49/302)] with hearing preservation in 70.2%(212/302) of patients;85.7%(18/21) for double canal plugging [class A 61.9%(13/21), class B 23.8%(5/21)] with hearing preservation in 76.2%(16/21) of patients;and 60.0%(3/5) in single canal plugging [class A 40.0%(2/5), class B 20.0%(1/5) with hearing preservation in 80.0%(4/5) of patients. While vertigo control was the best among the three groups (P<0.05), there was no difference in hearing preservation (P>0.05). Conclusion Semicircular canal plugging is an effective treatment for intractable Meniere’s disease, with three canal plugging being the best in vertigo control.