10-year review of endolymphatic sac surgery for intractable meniere disease.
Bibliographic record
Abstract
OBJECTIVE: To review our 10-year experience of endolymphatic sac surgery (ESS) for intractable Meniere disease (MD). DESIGN: Retrospective chart review and survey. SETTING: Tertiary care centre. METHODS: Patients presenting for ESS from 1998 to 2007 were reviewed using the 1995 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guidelines. A quality of life (QOL) questionnaire was mailed out using the Dillman method. MAIN OUTCOME MEASURES: (1) 1995 AAO-HNS hearing stage, vertigo class, and functional level; (2) complications and secondary treatments; (3) a 40-question, disease-specific, validated QOL questionnaire (Meniere's Disease Outcome Questionnaire). RESULTS: Thirty patients (33 ears) had ESS (63.6% male, mean age 49 years, mean follow-up 30.6 months). Vertigo control was 35.5% class A, 29.0% class B, 6.5% class C, 0% class D, 3.2% class E, and 25.8% class F. If class A and B are considered successful, then 64.5% were successful. Hearing stage improved in 14.8%, remained the same in 51.9%, and worsened in 33.3%. Average preoperative functional level was 4.3 and postoperative level was 3.5 (p = .0016). Secondary treatment after ESS was performed in 26%. Three patients (10.0%) had profound sensorineural hearing loss. Twenty-five questionnaire responses (75.8%) were received. There was a significant increase in QOL scores (p = .000001), and 80% had an improvement in QOL scores. CONCLUSIONS: ESS is a surgical option for MD that offers relief from vertigo in selected patients, but patients need to be cautioned about the risk of hearing loss and the requirement for subsequent destructive treatment in a significant proportion of cases.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.004 | 0.003 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".