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Updated: Nov 8, 2025

Endolymphatic Duct Blockage as a Surgical Treatment Option for Ménière's Disease
Published on: April 28, 2023
Changes in the Results of the Subjective Visual Vertical Test After Endolymphatic Sac Drainage for Intractable
Tomoyuki Shiozaki1, Yoshiro Wada1, Taeko Ito1
1Department of Otolaryngology-Head and Neck Surgery, Nara Medical University, Kashihara City, Nara, Japan.
Objective:
To investigate otolithic function before and after endolymphatic sac drainage (ELSD) for Meniere's disease (MD) by using the subjective visual vertical test (SVV) in the upright and tilted positions.
Methods:
Eighteen patients with definite unilateral MD diagnosed in accordance with the American Academy of Otolaryngology Head and Neck Surgery criteria in 1995 and Barany Society criteria in 2015 were included. SVV in the upright position and the head-tilt position was performed preoperatively and on postoperative days 1, 5, 8, 28, and 112. Changes in the results of SVV in the upright position (UP-SVV) and head-tilt perception gain (HTPG) after surgery were measured.
Results:
The average UP-SVV values significantly changed from 0.05° by the affected side before surgery to 2.5° by the unaffected side on the fifth postoperative day, followed by recovery to the normal range by the eighth postoperative day. The HTPG values for the unaffected side showed the maximum increase on postoperative day 5 during the present study period, although the values in the affected side did not alter significantly.
Conclusion:
ELSD for MD is a surgical treatment that involves less risk of otolith function damage and abnormalities in gravitational cognition. SVV in the head-tilt position could be one of the neuro-otologic examinations used to easily understand the vestibular compensatory process.

