[Results of surgery of the endolymphatic sac]

Surgery of the endolymphatic sac is controversial. Some consider it a placebo and others consider it the surgical treatment of choice in Ménière's disease. We studied the medical records of 87 patients who underwent surgery between 1978 and 1996. Simple decompression was practiced in 89% and a House shunt in 27.6%. The 1-year results were improvement or recovery from vertigo in 65.4%, no improvement in 25%, and reoperation in 9.5%. Tinnitus improved in only 11.9% and hearing loss improved in 9.5% and worsened in 19%. We reviewed the cases of 50 patients with a 5-year follow-up(60%). Vertigo improved in 72%,hearing loss worsened in 72%, and tinnitus remained unchanged in 78%. In view of the good results, scant complications and simplicity of the surgical procedure, we consider endolymphatic saccule surgery to be the first choice in Ménière's disease that is unresponsive to medical treatment.