Current state of evidence for endolymphatic sac surgery in Menière’s disease: a systematic review

Abstract

Background: Endolymphatic sac surgery is an invasive procedure recommended to patients with Menière’s disease.

Aims/Objectives: 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.

Material and Methods: 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.

Results: 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.

Conclusions and significance: 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.

背景：内淋巴囊手术是一种侵袭性的, 适用于脑膜炎患者的手术。

目的：提供对现有证据的总述和质量评估, 并对应用于脑膜疾病的内淋巴囊手术进行最新评估。

材料和方法：为进行系统总述和随机对照试验（RCT）, 我们做了系统的文献检索。AMSTAR工具用于评估系统评价的质量和RCT偏倚工具的Cochrane风险。采用GRADE法评估个体结果的总体确定性。

结果：一项高质量的系统评价符合入选标准, 它包括三项随机对照试验。自最近一次审查的检索日期开始的更新文献检索并没有提供进一步的相关RCT。确定的随机对照试验报告了手术后安慰剂组和积极治疗组的良性作用, 突出显示着安慰剂效应。这种效果的总体确定性很低。

结论和意义：目前仍缺乏高质量的研究。这表明, 内淋巴囊手术为脑膜患者提供了很大程度的症状缓解。

Keywords:

• Menière's disease
• endolymphatic shunt
• vertigo
• endolymphatic surgery

Disclosure statement

The authors report no conflict of interest.