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

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  • Casper Grønlund
  • Louise Devantier
  • Henriette Edemann Callesen
  • Dan Dupont Hougaard
  • Mina Nicole Händel
  • Jesper Hvass Schmidt
  • Frank Liviu-Adelin Guldfred
  • Bjarki Ditlev Djurhuus
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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.

Original languageEnglish
Article number190098SR
JournalInternational Archives of Otorhinolaryngology
Issue number3
Pages (from-to)e463-e470
Publication statusPublished - Jul 2021

    Research areas

  • Dizziness, Hearing, Meniere disease, Ventilation tube insertion, Vertigo

ID: 67551919