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A summary of vertigo control and hearing preservation
in the short-term (
9
12 mo) is provided in Tables 1 and 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
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%)
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.
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. 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. 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.
A. J. SOOD ET AL.
Otology & Neurotology, Vol. 35, No. 6, 2014
59