Health Utility Improves After Surgery for Superior Canal Dehiscence Syndrome

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Abstract

Objective:

Health utility value (HUV) is an outcome measure used to calculate quality adjusted life years (QALYs) and to determine cost-effectiveness of medical treatments. Herein, we measure HUV in patients with superior canal dehiscence syndrome (SCDS) before and after surgical repair. Health utility values of patients with SCDS are compared to normative data of the general United States population.

Study Design:

Retrospective review of prospectively collected data.

Patients:

Adult patients with SCDS.

Setting:

Tertiary referral center.

Interventions:

SCD repair via middle fossa craniotomy or transmastoid approaches.

Main Outcome Measure:

Primary outcome: change in HUV, as measured by the Short-Form 6-Dimension questionnaire. Secondary outcomes: autophony index (AI), dizziness handicap inventory (DHI), and hearing handicap inventory (HHI).

Results:

Fifty-one patients with SCDS were enrolled, 23 underwent surgical repair. Mean HUV in patients with SCDS is significantly lower than the general U.S. population: 0.68 (SD = 0.13) versus 0.80 (0.29), p < 0.01, respectively. Patients electing to undergo surgical repair had similar values relative to nonoperated patients: 0.65 (0.13) versus 0.71 (0.14), p = 0.20, respectively. At mean follow-up of 12 months (range 3–39), postoperative HUV improved to 0.79 (0.12), p < 0.01. AI decreased (improved) after repair: 32.7 (28.0) to 4.8 (8.3), p < 0.001. DHI and HHI did not change significantly after surgery, p > 0.14. Nonoperated patients had no significant change in HUV during a mean follow-up period of 21 months (range 9–39), p = 0.33.

Conclusions:

SCDS patients have significantly lower HUV compared with the general U.S. population. HUV demonstrated improvement after surgery. Nonoperated patients have ongoing impaired quality of life.

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