2005 年 98 巻 1 号 p. 21-25
This study evaluated the efficacy of endolymphatic sac-expanding surgery in comparison with medical treatment for intractable Meniere's disease. The outcomes of 47 patients with intractable Meniere's disease who underwent endolymphatic sac-expanding surgery were retrospectively compared with those of 22 patients who were offered surgery but preferred to continue medical treatment instead. Age, gender, disease duration, frequency of attacks and stage of hearing before treatment were almost equally distributed in both the surgically and medically treated groups. The outcomes were analyzed according to the 1995 AAO-HNS reporting guidelines. Definitive spells were completely controlled in approximately 90% of cases every year and hearing was improved in approximately 30% of cases for 0.5 to 6 years after surgery. Statistical analysis demonstrated that endolymphatic sac-expanding surgery is superior to medical treatment, at least from the perspective of immediate improvement in the quality of life. However, the proportion of cases showing hearing deterioration increased from 4% to 26% over 6 years after surgery. We would like to emphasize that further effort to improve and avoid deterioration in hearing remains urgent.