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A. J. SOOD ET AL.

FIG. 12. Vertigo control: Forest plot for mastoid shunt (including both with and without silastic sheeting) with Category A/B vertigo control at a minimum of 24 months of follow-up. +ss indicates with silastic sheeting; j ss, without silastic sheeting.

FIG. 10. Vertigo control: Forest plot for endolymphatic sac de- compression with Category A/B vertigo control at a minimum of 24 months of follow-up.

A summary of vertigo control and hearing preservation in the short-term ( 9 12 mo) is provided in Tables 1 and 2.

was 34.0 months (range, 24 Y 132 mo). Postoperative hearing was stable or improved in 71.6% (95% CI, 59.2% Y 82.5%) of patients (Fig. 11). Mean PTA worsened by 1.4 dB (range, j 1.4 to 9.6 dB). Mastoid Shunts (With and Without Silastic). Vertigo: Thirteen articles, totaling 966 patients, were analyzed to determine the efficacy of current mastoid shunting pro- cedures in controlling vertigo symptoms. Mean follow-up was 40.7 months (range, 24 Y 72 mo). Complete or sub- stantial (Category A/B) vertigo control was achieved in 75.7% (95% CI, 69.8% Y 81.2%) of patients (Fig. 12). Hearing: Eight articles, totaling 549 patients, were ana- lyzed to determine the efficacy of current mastoid shunting procedures in hearing preservation. Mean follow-up was 41.5 months (range, 24 Y 132 mo). Postoperative hearing was stable or improved in 69.3% (95% CI, 60.9% Y 77.2%)

Long-term Analysis

Endolymphatic Sac Decompression Versus Mastoid Shunt

Endolymphatic Sac Decompression. Vertigo: Four ar- ticles, totaling 196 patients, were analyzed to determine the efficacy of endolymphatic sac decompression in controlling vertigo. Mean follow-up was 34.8 months (range, 24 Y 55 mo). Complete or substantial (Category A/B) vertigo control was achieved in 81.6% (95% CI, 61.0% Y 95.7%) of patients (Fig. 10). Hearing: Five articles, totaling 211 patients, were ana- lyzed to determine the efficacy of endolymphatic sac decompression in hearing preservation. Mean follow-up

FIG. 11. Hearing outcomes: Forest plot for endolymphatic sac decompression with hearing improved or stable at a minimum of 24 months of follow-up.

FIG. 13. Hearing outcomes: Forest plot for mastoid shunt (in- cluding both with and without silastic sheeting) with hearing im- proved or stable at a minimum of 24 months of follow-up.

Otology & Neurotology, Vol. 35, No. 6, 2014

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