Tenotomy of the stapedius and tensor tympani muscles reduces subjective dizziness handicap in definite Meniere's disease

Abstract

Conclusion: Tenotomy is a promising surgical alternative with a high reduction in dizziness handicap in the short and long term. Objectives: To investigate the immediate and the long-term effect of tenotomy of the stapedius and tensor tympani muscles on subjective dizziness as measured by the Dizziness Handicap Inventory (DHI). Methods: A retrospective follow-up study of 42 patients with definite, unilateral Meniere's disease (19 males, 23 females, average age = 58.1 ± 14.1 years) had undergone tenotomy under general anesthesia through an endaural approach. Pre- and postoperative DHI values were compared for all patients, with postoperative follow-up ranging from 6 months to 9 years. Additionally, results were divided into three postoperative subgroups (A = 0–3 years, B = 3–6 years, C = 6–9 years). Results: A statistically significant reduction of 48 DHI points, from a median preoperative DHI = 52 to DHI = 4 postoperatively, was noted (p < 0. 001). In all, 40/42 patients reported a reduction of dizziness handicap, while in 33/42 the difference was > 12 points. A statistically significant reduction of DHI scores was noted (A = 60, B = 34, C = 33) in all subgroups. It was also noted that the higher the preoperative DHI score, the greater the subjective success of the surgery.

Keywords::

• Dizziness
• vertigo
• hearing loss
• middle ear
• Dizziness Handicap Inventory

Acknowledgment

This project was supported by the ENT Department, Medical University of Vienna.

Declaration of interest: The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the paper.