TY - JOUR

T1 - Vertiginous episodes in menière disease following transmyringeal ventilation tube insertion

T2 - A systematic review on the current state of evidence

AU - Grønlund, Casper

AU - Devantier, Louise

AU - Callesen, Henriette Edemann

AU - Hougaard, Dan Dupont

AU - Händel, Mina Nicole

AU - Schmidt, Jesper Hvass

AU - Guldfred, Frank Liviu Adelin

AU - Djurhuus, Bjarki Ditlev

N1 - Publisher Copyright: Copyright © by Thieme Revinter Publicações Ltda, Rio de Janeiro, Brazil.

PY - 2021

Y1 - 2021

N2 - Introduction Menière disease (MD) is a disorder characterized by episodes of vertigo, sensorineural hearing loss, tinnitus and aural fullness. Objectives To assess the effect of ventilation tube insertion (VTI) on vertiginous episodes in patients (≥ 18 years old) with MD. Data Synthesis A systematic literature search on randomized clinical trials (RCTs), nonrandomized trials and other systematic reviews was performed. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach was used to assess the overall certainty of evidence. Two RCTs and four nonrandomized studies were identified. Data extraction was only possible for one RCT. Results showed that the number of patients with no vertigo attacks significantly increased following active treatment (relative risk 1.52; [95% confidence interval: 1.19-1.94]). The quality of evidence was rated as low. None of the nonrandomized trials included a proper control group, which hindered data extraction and quality assessment. Conclusion There are currently no RCTs that specifically assess the efficacy of VTI in patients with MD. Current limited data suggest a considerable positive effect on the number of vertiginous episodes in patients with MD. However, due to poor evidence, a fluctuating course and a substantial placebo-effect associated with MD-treatment, no solid conclusion(s) regarding the efficacy of VTI can be made. There is a need for high-quality RCTs.

AB - Introduction Menière disease (MD) is a disorder characterized by episodes of vertigo, sensorineural hearing loss, tinnitus and aural fullness. Objectives To assess the effect of ventilation tube insertion (VTI) on vertiginous episodes in patients (≥ 18 years old) with MD. Data Synthesis A systematic literature search on randomized clinical trials (RCTs), nonrandomized trials and other systematic reviews was performed. The Grades of Recommendation, Assessment, Development, and Evaluation (GRADE) approach was used to assess the overall certainty of evidence. Two RCTs and four nonrandomized studies were identified. Data extraction was only possible for one RCT. Results showed that the number of patients with no vertigo attacks significantly increased following active treatment (relative risk 1.52; [95% confidence interval: 1.19-1.94]). The quality of evidence was rated as low. None of the nonrandomized trials included a proper control group, which hindered data extraction and quality assessment. Conclusion There are currently no RCTs that specifically assess the efficacy of VTI in patients with MD. Current limited data suggest a considerable positive effect on the number of vertiginous episodes in patients with MD. However, due to poor evidence, a fluctuating course and a substantial placebo-effect associated with MD-treatment, no solid conclusion(s) regarding the efficacy of VTI can be made. There is a need for high-quality RCTs.

KW - Dizziness

KW - Hearing

KW - Meniere disease

KW - Ventilation tube insertion

KW - Vertigo

U2 - 10.1055/s-0040-1714131

DO - 10.1055/s-0040-1714131

M3 - Review

C2 - 34377186

AN - SCOPUS:85093645477

VL - 25

SP - e463-e470

JO - International Archives of Otorhinolaryngology

JF - International Archives of Otorhinolaryngology

SN - 1809-9777

IS - 3

ER -