Simultaneous Cochlear Implantation and Labyrinthine Surgery for Meniere Disease: Endolymphatic Sac Decompression Versus Labyrinthectomy. Otol Neurotol 2026 Jul 01;47(6):818-825
Date
05/14/2026Pubmed ID
42132468DOI
10.1097/MAO.0000000000004861Scopus ID
2-s2.0-105042118973 (requires institutional sign-in at Scopus site)Abstract
INTRODUCTION: Patients with medically refractory Meniére disease (MD) may present with concomitant vertigo attacks and severe-profound hearing loss (SNHL). In such cases, simultaneous labyrinthectomy/cochlear implantation (CI) is a viable treatment option. Simultaneous endolymphatic sac decompression (ESD) and CI is less well described but represents a promising alternative. This study aims to analyze outcomes after simultaneous or staged ESD/CI as compared with simultaneous labyrinthectomy/CI.
MATERIALS AND METHODS: MD patients undergoing simultaneous or staged ESD/CI and simultaneous labyrinthectomy/CI were reviewed from 2 tertiary care centers. Inclusion criteria included: ≥ 2 vertigo attacks/week, supportive vestibular testing, normal MRI, SNHL meeting criteria for CI, and average sodium intake of 1200 to 1500 mg/day. Demographic data, surgical complications, audiometric outcomes, and vestibular outcomes were analyzed.
RESULTS: Eighteen patients (19 ears) were included. Six patients (7 ears) underwent either simultaneous or staged ESD/CI, and 12 patients (12 ears) underwent labyrinthectomy/CI. Vertigo attacks decreased in 71.4% of ESD/CI patients and 100% of labyrinthectomy/CI patients. 6/7 ears in the ESD/CI cohort had improved AzBio sentence scores with an average improvement of 85.6% in quiet, 64.8% in +10 SNR, ( P <0.05), and 77.5% improvement in monosyllabic word scores ( P <0.05). Of the 9 patients in the labyrinthectomy/CI cohort with adequate data, 7 showed improved AzBio-Q sentence scores with an average improvement of 57.6% ( P <0.05) at the most recent follow-up.
CONCLUSIONS: Simultaneous ESD/CI was safe and effective. Vestibular and hearing outcomes after this approach were comparable to those associated with labyrinthectomy/CI. ESD/CI may be associated with a lower rate of vertigo resolution than labyrinthectomy/CI.
LEVEL OF EVIDENCE: Level IV, retrospective case series.
Author List
Jukic A, Elms HL, Steed AH, House T, Flores N, Cismas M, Nelson RF, Stevens SMAuthor
Hunter L. Elms BS, MD Assistant Professor in the Otolaryngology and Communication Sciences department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AdultAged
Cochlear Implantation
Decompression, Surgical
Ear, Inner
Endolymphatic Sac
Female
Humans
Male
Meniere Disease
Middle Aged
Otologic Surgical Procedures
Retrospective Studies
Treatment Outcome
Vertigo
