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

Introduction Outcomes of surgery for Meniere'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 chi(2) 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.Analysis and support of clinical decision makin

Air-bone gap in patients with X-linked stapes gusher syndrome

Contains fulltext : 21348.PDF (publisher's version ) (Open Access

Port expansion project: Port of Phillipsburg St. Maarten Netherlands Antilles

The Sint Maarten Ports Authority (SMPA) , wishes to expand the present port of Phillipsburg, due to the increase of cargo throughput and forecast for the cruise tourism. The SMPA has appointed Grabowsky&Poort International BV as the main consultants for the port development. To give this report a more complete character, a summary of the Port Lay-out Study, the Wave Climate Study [ref.: 3J and the wave Penetration Study [ref.: 2J are included. These three studies were performed during my work emplacement at GrabowskY&Poort International BV.Hydraulic EngineeringCivil Engineering and Geoscience

CADOB, Computer Aided Breakwater Design

Publication year estimated. Computer program to design breakwater cross-sectionsCado