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
PY - 2021/7/1
Y1 - 2021/7/1
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
UR - http://www.scopus.com/inward/record.url?scp=85093645477&partnerID=8YFLogxK
U2 - 10.1055/s-0040-1714131
DO - 10.1055/s-0040-1714131
M3 - Review article
C2 - 34377186
SN - 1809-9777
VL - 25
SP - e463-e470
JO - International Archives of Otorhinolaryngology
JF - International Archives of Otorhinolaryngology
IS - 3
ER -