Affiliation:
1. Pritzker School of Medicine University of Chicago Chicago Illinois USA
2. Department of Surgery, Section of Otolaryngology University of Chicago Medicine Chicago Illinois USA
Abstract
AbstractObjectiveThis study used a national insurance claims database to analyze trends in procedural management of Meniere's disease.Study DesignRetrospective cohort analysis.SettingDatabase study using United States inpatient and outpatient insurance claims submitted from January 2003 to December 2021.Subjects and MethodsThe Merative MarketScan Commercial and Medicare Claims Databases were queried for adults (≥18 years) with a diagnosis of Meniere's Disease according to International Classification of Diseases codes. Patients receiving procedures per Current Procedural Terminology codes for endolymphatic sac surgery, vestibular nerve section, labyrinthectomy, and intratympanic dexamethasone or gentamicin were identified. Temporal trends were analyzed by calculating annual percent change (APC) in the proportion of patients receiving procedures using Joinpoint regression.ResultsA total of 16,523 unique patients with MD receiving procedural management were identified. From 2003 to 2021, the proportion of patients managed with intratympanic dexamethasone increased (APC 1.76 [95% CI 1.53‐1.98], P < .001). The proportion of patients receiving intratympanic gentamicin increased from 2003 to 2015 (APC 4.43 [95% CI 1.29‐7.66], P = .008) but decreased from 2015 to 2021 (APC −10.87 [95% CI −18.31 to −2.76], P = .013). The proportion of patients receiving endolymphatic sac surgery (APC: −10.20 [95% CI −11.19 to −9.20], P < .001) and labyrinthectomy (APC: −6.29 [95% CI −8.12 to −4.42], P < .001) decreased from 2003 to 2021.ConclusionFrom 2003 to 2021, there has been an increase in the use of intratympanic dexamethasone and a decrease in the use of intratympanic gentamicin, endolymphatic sac surgery, and labyrinthectomy for procedural management of Meniere's Disease.