Outcomes of Endolymphatic Sac Surgery for Meniere’s Disease with and without Comorbid Migraine

Abstract

Purpose. To explore outcomes of endolymphatic sac surgery for patients with Meniere’s disease with and without the comorbid condition of migraine. Materials and Methods. A retrospective chart review of adult patients undergoing endolymphatic sac surgery at a single tertiary care center from 1987 to 2019 was performed. All adult patients who failed medical therapy and underwent primary endolymphatic sac surgery were included. The main outcome measures were vertigo control and functional level scale (FLS) score. Patient characteristics, comorbidities, and audiometric outcomes were tracked as well. Results. Patients with Meniere’s disease and migraine had a stronger association with psychiatric comorbidities (64.29% vs. 25.80%, $p=0.01$ ), shorter duration of vertigo episodes (143 vs. 393 min, $p=0.02$ ), and younger age (36.6 vs. 50.8 yr, $p=0.005$ ) at the time of endolymphatic sac surgery. Postoperative pure tone averages and word recognition scores were nearly identical to preoperative baselines. Class A vertigo control (47.92%) was most common, followed by class B vertigo control (31.25%). The FLS score improved from 4.2 to 2.8 ( $p<0.001$ ). Both patients with and without migraine had classes A-B vertigo control (66.67% vs. 80.95%) without any statistically significant difference ( $p=0.59$ ). Of the patients who required secondary treatment (10.42%), none had migraine. Conclusions. Endolymphatic sac surgery is an effective surgical intervention for Meniere’s disease with and without migraine. Patients with comorbid migraine tend to be younger and present with psychiatric comorbidities.