Effectiveness of endolymphatic duct blockage versus endolymphatic sac decompression in patients with intractable Ménière’s disease: study protocol for a double-blinded, randomised controlled trial

Introduction Outcomes of surgery for Ménière’s disease (MD) remain discordant. Recently, a new surgical procedure in which the endolymphatic duct is clipped was proposed. To date, only one prospective trial assessing this technique was published, yielding promising results. This protocol describes a...

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Main Authors: Stefan Böhringer, Suzanne C Cannegieter, Wilbert B van den Hout, Sebastiaan Hammer, Annejet A Schenck, Josephina M Kruyt, Peter Paul van Benthem, Susan P M Hombergen, Henk M Blom
Format: Article
Language:English
Published: BMJ Publishing Group 2021-08-01
Series:BMJ Open
Online Access:https://bmjopen.bmj.com/content/11/8/e054514.full
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author Stefan Böhringer
Suzanne C Cannegieter
Wilbert B van den Hout
Sebastiaan Hammer
Annejet A Schenck
Josephina M Kruyt
Peter Paul van Benthem
Susan P M Hombergen
Henk M Blom
author_facet Stefan Böhringer
Suzanne C Cannegieter
Wilbert B van den Hout
Sebastiaan Hammer
Annejet A Schenck
Josephina M Kruyt
Peter Paul van Benthem
Susan P M Hombergen
Henk M Blom
author_sort Stefan Böhringer
collection DOAJ
description Introduction Outcomes of surgery for Ménière’s disease (MD) remain discordant. Recently, a new surgical procedure in which the endolymphatic duct is clipped was proposed. To date, only one prospective trial assessing this technique was published, yielding promising results. This protocol describes a prospective, double-blinded, randomised controlled trial that will be carried out to assess the effectiveness of this surgical intervention.Methods Eighty-four patients with intractable MD will be recruited from 13 hospitals in the Netherlands. Intraoperatively, randomisation will determine whether endolymphatic duct blockage (EDB) or endolymphatic sac decompression (ESD) will be performed. Randomisation will be 1:1 stratified for gender and duration of MD (recent-onset versus mature MD). All participants receive vestibular rehabilitation after surgery. Patients are followed up during 1 year after surgery. Follow-up visits will take place at 1 week, 3 months, 6 months and 12 months after surgery. The main study endpoint is proportion of patients who are free of vertigo spells at 12 months postoperatively. Secondary parameters include cumulative number of vertigo bouts, co-intervention, tinnitus, hearing, quality of life, cost effectiveness and a budget impact analysis. Total duration of the study is 4 years.Analysis The primary analysis will follow the intention-to-treat principle. For the primary outcome, a χ2 test will be performed. Secondary outcomes will be analysed using a linear mixed model (EDB versus decompression group) at the different time measurement point.Ethics and dissemination This study was reviewed and approved by a board of specialists before funding was obtained, as well as by the Medical Research Ethics Committee Leiden-The Hague-Delft and the boards of all participating centres. Results of this study will be published in international peer-reviewed scientific journals and will be presented on (inter)national scientific conferences and meetings.Trial registration numbers NL9095 and ISRCTN12074571; Pre-Results.
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spelling doaj-art-2d104139bd3d492ab54234cfc45a0c8c2025-08-20T02:31:17ZengBMJ Publishing GroupBMJ Open2044-60552021-08-0111810.1136/bmjopen-2021-054514Effectiveness of endolymphatic duct blockage versus endolymphatic sac decompression in patients with intractable Ménière’s disease: study protocol for a double-blinded, randomised controlled trialStefan Böhringer0Suzanne C Cannegieter1Wilbert B van den Hout2Sebastiaan Hammer3Annejet A Schenck4Josephina M Kruyt5Peter Paul van Benthem6Susan P M Hombergen7Henk M Blom8Department of Biomedical Data Sciences, Leiden University Medical Centre, Leiden, The NetherlandsDepartment of Clinical Epidemiology, Leiden University Medical Center, Leiden, Zuid-Holland, The NetherlandsDepartment of Medical Decision Making, Leiden University Medical Centre, Leiden, The NetherlandsDepartment of Radiology, Haga Hospital, The Hague, The NetherlandsDepartment of Otorhinolaryngology, Haga Hospital, The Hague, The NetherlandsDepartment of Otorhinolaryngology, Medical Centre Haaglanden, The Hague, The NetherlandsDepartment of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden, The NetherlandsDepartment of Physiotherapy, Haga Hospital, The Hague, The NetherlandsDepartment of Otorhinolaryngology, Haga Hospital, The Hague, The NetherlandsIntroduction Outcomes of surgery for Ménière’s disease (MD) remain discordant. Recently, a new surgical procedure in which the endolymphatic duct is clipped was proposed. To date, only one prospective trial assessing this technique was published, yielding promising results. This protocol describes a prospective, double-blinded, randomised controlled trial that will be carried out to assess the effectiveness of this surgical intervention.Methods Eighty-four patients with intractable MD will be recruited from 13 hospitals in the Netherlands. Intraoperatively, randomisation will determine whether endolymphatic duct blockage (EDB) or endolymphatic sac decompression (ESD) will be performed. Randomisation will be 1:1 stratified for gender and duration of MD (recent-onset versus mature MD). All participants receive vestibular rehabilitation after surgery. Patients are followed up during 1 year after surgery. Follow-up visits will take place at 1 week, 3 months, 6 months and 12 months after surgery. The main study endpoint is proportion of patients who are free of vertigo spells at 12 months postoperatively. Secondary parameters include cumulative number of vertigo bouts, co-intervention, tinnitus, hearing, quality of life, cost effectiveness and a budget impact analysis. Total duration of the study is 4 years.Analysis The primary analysis will follow the intention-to-treat principle. For the primary outcome, a χ2 test will be performed. Secondary outcomes will be analysed using a linear mixed model (EDB versus decompression group) at the different time measurement point.Ethics and dissemination This study was reviewed and approved by a board of specialists before funding was obtained, as well as by the Medical Research Ethics Committee Leiden-The Hague-Delft and the boards of all participating centres. Results of this study will be published in international peer-reviewed scientific journals and will be presented on (inter)national scientific conferences and meetings.Trial registration numbers NL9095 and ISRCTN12074571; Pre-Results.https://bmjopen.bmj.com/content/11/8/e054514.full
spellingShingle Stefan Böhringer
Suzanne C Cannegieter
Wilbert B van den Hout
Sebastiaan Hammer
Annejet A Schenck
Josephina M Kruyt
Peter Paul van Benthem
Susan P M Hombergen
Henk M Blom
Effectiveness of endolymphatic duct blockage versus endolymphatic sac decompression in patients with intractable Ménière’s disease: study protocol for a double-blinded, randomised controlled trial
BMJ Open
title Effectiveness of endolymphatic duct blockage versus endolymphatic sac decompression in patients with intractable Ménière’s disease: study protocol for a double-blinded, randomised controlled trial
title_full Effectiveness of endolymphatic duct blockage versus endolymphatic sac decompression in patients with intractable Ménière’s disease: study protocol for a double-blinded, randomised controlled trial
title_fullStr Effectiveness of endolymphatic duct blockage versus endolymphatic sac decompression in patients with intractable Ménière’s disease: study protocol for a double-blinded, randomised controlled trial
title_full_unstemmed Effectiveness of endolymphatic duct blockage versus endolymphatic sac decompression in patients with intractable Ménière’s disease: study protocol for a double-blinded, randomised controlled trial
title_short Effectiveness of endolymphatic duct blockage versus endolymphatic sac decompression in patients with intractable Ménière’s disease: study protocol for a double-blinded, randomised controlled trial
title_sort effectiveness of endolymphatic duct blockage versus endolymphatic sac decompression in patients with intractable meniere s disease study protocol for a double blinded randomised controlled trial
url https://bmjopen.bmj.com/content/11/8/e054514.full
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