Multiple perioperative interventions increase hearing preservation rate in triple semicircular canal occlusion for intractable Menierès disease: a retrospective matched case–control study

Background Triple semicircular canal occlusion (TSCO) is effective for vertigo control in Meniere’s disease (MD), yet postoperative hearing deterioration remains a concern.Objectives To determine whether a multimodal perioperative hearing-preservation strategy reduces hearing loss following TSCO.Material and Methods In this retrospective matched case–control study, 28 TSCO patients receiving perioperative interventions—including intraoperative electrocochleography (ECochG), low-speed drilling, simultaneous canal fenestration, dexamethasone irrigation, and postoperative corticosteroids with betahistine—were matched 1:1 with controls. Pure-tone audiometry was conducted preoperatively and at 3 months postoperatively.Results The intervention group demonstrated significantly smaller PTA change (5.10 ± 9.85 vs. 16.80 ± 15.20 dB HL, p < 0.05) and a higher hearing preservation rate (82.1% vs. 42.9%). Patients with intraoperative ECochG fluctuations experienced greater postoperative hearing deterioration (12.40 ± 6.48 vs. 0.52 ± 3.28 dB HL, p < 0.01).Conclusions Multimodal perioperative interventions significantly improve short-term hearing outcomes after TSCO. ECochG monitoring provides real-time functional feedback and may reduce cochlear injury risk.Significance These findings support standardized perioperative hearing-protection protocols and highlight ECochG as a valuable adjunct to improve the safety and acceptance of TSCO in refractory MD.