Devantier Louise, Schmidt Jesper Hvass, Djurhuus Bjarki Ditlev, Hougaard Dan Dupont, Händel Mina Nicole, Liviu-Adelin Guldfred Frank, Edemann-Callesen Henriette
Department of Clinical Medicine, Aarhus University , Aarhus , Denmark.
Department of Oto-Rhino-Laryngology, Regional Hospital West Jutland , Holstebro , Denmark.
Acta Otolaryngol. 2019 Nov;139(11):953-958. doi: 10.1080/00016489.2019.1657240. Epub 2019 Sep 9.
Endolymphatic sac surgery is an invasive procedure recommended to patients with Menière's disease. To provide an overview and quality assessment of the existing evidence and to provide an updated assessment of the utility of endolymphatic sac surgery in Menière's disease. We performed a systematic literature search for systematic reviews and randomized controlled trials (RCTs). The AMSTAR tool was used to assess the quality of systematic reviews and the Cochrane risk of bias tool for RCTs. The overall certainty of effects for the individual outcomes was evaluated using the GRADE approach. One systematic review of high quality matched the inclusion criteria, and included three RCTs. An updated literature search from the last search date of the included review provided no further relevant RCTs. The identified RCTs individually reported a positive effect of both the placebo and active treatment groups following surgery, strongly indicative of a placebo effect. The overall certainty of the effect was very low. There is still a lack of high-quality research suggesting that endolymphatic sac surgery provides a significant amount of symptomatic relief for Menière's patients.
内淋巴囊手术是一种推荐给梅尼埃病患者的侵入性手术。目的是对现有证据进行概述和质量评估，并对梅尼埃病内淋巴囊手术的效用进行最新评估。我们对系统评价和随机对照试验（RCT）进行了系统的文献检索。使用AMSTAR工具评估系统评价的质量，使用Cochrane偏倚风险工具评估RCT的质量。采用GRADE方法评估个体结局效应的总体确定性。一项高质量的系统评价符合纳入标准，其中包括三项RCT。对纳入评价的最后检索日期进行的更新文献检索未发现进一步相关的RCT。已识别的RCT分别报告了手术后脑膜炎组和活跃治疗组均有积极效果，强烈表明存在安慰剂效应。效应的总体确定性非常低。仍然缺乏高质量的研究表明内淋巴囊手术能为梅尼埃病患者提供显著的症状缓解。
