Evaluation of quality of life after intratympanic streptomycin injection in patients with Ménière's disease.

Abstract

Objectives: Quality of life (QOL) and satisfaction level of patients with Ménière's disease who underwent intratympanic streptomycin injection were evaluated across physical, psychological, and social domains of function.

Study Design: Preoperative and postoperative QOL of patients were evaluated based on the chart records of patients and questionnaire surveys. From January 2000 to August 2005, 81 patients underwent intratympanic streptomycin injection at Yonsei University Severance Hospital, and their medical records were retrospectively reviewed. In addition, a mailed questionnaire survey was conducted. Ménière's Disease Outcome Questionnaire-Retrospective Version, proposed by Kato et al., was used as the QOL measure and was completed by 51 patients.

Results: The average QOL score was 35.6 ± 9.6 before surgery and 52.8 ± 10.3 after surgery, indicating improvement of QOL by 17.2 after surgery. The improvement of QOL score did not correlate to age and sex of patients; nonetheless, higher improvement of score was found in patients with professional career (p < 0.001). The improvement of QOL in the preoperative Stage 3 and 4 patient groups was greater than that in the preoperative Stage 1 and 2 patient groups (p = 0.032). The mean change in hearing of the patients after surgery was 1.5 + 7.2 dB hearing loss based on a 4-frequency pure-tone average (500, 1,000, 2,000, 3,000 Hz). Furthermore, 4 (7.8%) of 51 patients demonstrated greater than 10-dB change in 4-frequency pure-tone average. The status of hearing loss after surgery did not influence the QOL score (p = 0.530). As the frequency of vertigo decreased, the improvement of QOL score increased (p = 0.042).

Conclusion: The level of satisfaction with intratympanic streptomycin injection was strongly correlated to the QOL score in Ménière's Disease Outcome Questionnaire-Retrospective Version. As for the factors that improved the QOL after surgery, the status of hearing was not closely associated; however, the frequency of vertiginous symptom was the most important factor.