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CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2021; 25(03): e463-e470
DOI: 10.1055/s-0040-1714131
Systematic Review

Vertiginous Episodes in Menière Disease following Transmyringeal Ventilation Tube Insertion: A Systematic Review on the Current State of Evidence

Casper Grønlund 
1   Department of Ear, Nose, Throat and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
,
Louise Devantier 
2   Department of Oto-Rhino-Laryngology, Regional Hospital West Jutland, Holstebro, Denmark
3   Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
,
Henriette Edemann Callesen 
4   The Danish Health Authority, Copenhagen, Denmark
,
Dan Dupont Hougaard 
5   Department of Otolaryngology, Head & Neck Surgery and Audiology, Aalborg University Hospital, Aalborg, Denmark
,
Mina Nicole Händel 
4   The Danish Health Authority, Copenhagen, Denmark
6   The Parker Institute, Copenhagen University Hospital, Bispebjerg and Frederiksberg, Copenhagen, Denmark
,
Jesper Hvass Schmidt 
7   Department of ORL, Head and Neck Surgery and Audiology, Odense University Hospital, Odense C, Denmark
8   Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, Odense, Denmark
,
Frank Liviu-Adelin Guldfred
9   Ear, Nose and Throat Clinic, Faxe, Denmark
,
Bjarki Ditlev Djurhuus 
1   Department of Ear, Nose, Throat and Maxillofacial Surgery, Zealand University Hospital, Koege, Denmark
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Abstract

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.

Keywords

ventilation tube insertion - Meniere disease - vertigo - dizziness - hearing

Final Comments

There are no RCTs that directly assess the efficacy of VTI on the number of vertiginous attacks in patients with definite or probable MD. Current data are suggestive of a considerable positive effect on the number of vertiginous attacks in patients with MD. However, due to poor quality data, the fluctuating course, and a substantial placebo effect associated with MD treatment, no solid conclusion(s) regarding the efficacy of VTI in patients with MD can be made. There is a need for high-quality RCTs on this matter.


Trial Registration Number

The protocol for the manuscript is registered in PROSPERO. Registration number: CRD42019134851, acceptance date: July 8, 2019. The present review was performed in accordance with the guidelines for systematic reviews and meta-analyses and Preferred Reported Items for Systemtic Reviews and Meta-analyses (PRISMA).




Publikationsverlauf

Eingereicht: 14. Januar 2020

Angenommen: 05. Juni 2020

Artikel online veröffentlicht:
30. September 2020

© 2020. Fundação Otorrinolaringologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commecial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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