Pullens Bas, Giard Johan Lodewijk, Verschuur Hendrik P, van Benthem Peter Paul
ENT Surgery, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, Netherlands, 3584 CX.
Cochrane Database Syst Rev. 2010 Jan 20(1):CD005395. doi: 10.1002/14651858.CD005395.pub2.
Ménière's disease is characterised by three major symptoms: vertigo, deafness, and tinnitus or aural fullness, all of which are discontinuous and variable in intensity. A number of surgical modalities, of varying levels of invasiveness, have been developed to reduce the symptoms of Ménière's disease, but it is not clear whether or not these are effective.
To assess the effectiveness of surgical options for the treatment of Ménière's disease. All surgical interventions used in the treatment of Ménière's disease, either to alter the natural history of the disease or to abolish vestibular function, were considered for this review.
We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; mRCT and additional sources for published and unpublished trials. The date of the most recent search was 25 February 2009.
Randomised or quasi-randomised controlled studies of a surgical modality versus a placebo therapy in Ménière's disease.
Two authors independently assessed trial quality and extracted data. Study authors were contacted for further information.
The only surgical intervention which has been evaluated in randomised controlled trials and met the inclusion criteria was endolymphatic sac surgery. We identified two randomised trials, involving a total of 59 patients; one comparing endolymphatic sac surgery with ventilation tubes and one with simple mastoidectomy. Neither study reported any beneficial effect of surgery either in comparison to placebo surgery or grommet insertion.
AUTHORS' CONCLUSIONS: The two trials included in this review provide insufficient evidence of the beneficial effect of endolymphatic sac surgery in Ménière's disease.
梅尼埃病的特征为三大主要症状：眩晕、耳聋以及耳鸣或耳胀满感，所有这些症状均为间断性且强度可变。已开发出多种侵袭性程度不同的手术方式来减轻梅尼埃病的症状，但这些方式是否有效尚不清楚。
评估手术治疗梅尼埃病的有效性。本综述纳入了所有用于治疗梅尼埃病的手术干预措施，这些措施旨在改变疾病的自然病程或消除前庭功能。
我们检索了Cochrane耳鼻喉疾病组试验注册库；Cochrane对照试验中央注册库（CENTRAL）；PubMed；EMBASE；CINAHL；科学引文索引；生物学文摘数据库；剑桥科学文摘；mRCT以及其他已发表和未发表试验的来源。最近一次检索日期为2009年2月25日。
梅尼埃病中手术方式与安慰剂治疗的随机或半随机对照研究。
两位作者独立评估试验质量并提取数据。联系研究作者获取更多信息。
在随机对照试验中评估且符合纳入标准的唯一手术干预措施是内淋巴囊手术。我们确定了两项随机试验，共涉及59名患者；一项将内淋巴囊手术与通气管进行比较，另一项将其与单纯乳突切除术进行比较。两项研究均未报告手术与安慰剂手术或鼓膜切开置管术相比有任何有益效果。
本综述纳入的两项试验提供的证据不足，无法证明内淋巴囊手术对梅尼埃病有有益效果。
