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Updated: Apr 14, 2026
Surgical Induction of Endolymphatic Hydrops by Obliteration of the Endolymphatic Duct
Published on: January 22, 2010
Efficacy of endolymphatic duct blockage in treating Ménière's disease
Tao Yang1,2,3, Zhiwen Zhang4,5, Qin Wang4,5
1Department of Otolaryngology-Head and Neck Surgery, Second Xiangya Hospital, Central South University, Changsha 410011. yt7065@csu.edu.cn.
Objectives:
Ménière's disease (MD) is an idiopathic inner ear disorder characterized by recurrent episodes of episodic rotational vertigo, fluctuating hearing loss, tinnitus, and a feeling of ear stuffiness. Endolymphatic sac (ES)-related surgery is used primarily in patients with MD who have failed to respond to pharmacologic therapy. Endolymphatic duct blockage (EDB) is a new procedure for the treatment of MD, and related clinical studies are still scarce. This study aims to investigate the dynamic changes in endolymphatic hydrops (EH) and the long-term surgical outcomes in MD patients undergoing EDB, and to evaluate the impact of different types of ES on the surgical efficacy.
Methods:
A retrospective analysis was conducted on 33 patients with refractory MD who underwent EDB. Based on the morphology of their endolymphatic sacs, patients were divided into a normal-type group (n=14) and an atrophic-type group (n=19). The frequency of vertigo symptoms, hearing, vestibular function, and the dynamic changes of gadolinium-enhanced MRI of the inner ear were compared were compared before and after surgery between the 2 groups.
Results:
Compared with the atrophic-type group, the patients in the normal-type group had a higher rate of complete vertigo control, better cochlear and vestibular function, and a lower endolymph to vestibule volume ratio (all P<0.05). In addition, 7 patients in the normal-type group were found to have reversal of EH, while no reversal of EH was detected in the atrophic-type group after surgery.
Conclusions:
The response to EDB treatment varies between normal and atrophic MD patients, suggesting that the 2 pathological types of endolymphatic sacs may have different underlying mechanisms of disease.
Insights
Endolymphatic duct blockage surgery for Ménière
Area of Science:
- Otolaryngology
- Neurosurgery
- Inner ear disorders
Background:
- Ménière's disease (MD) is an idiopathic inner ear condition causing vertigo, hearing loss, tinnitus, and ear fullness.
- Endolymphatic sac (ES) surgery is a treatment option for MD unresponsive to medication.
- Endolymphatic duct blockage (EDB) is an emerging surgical procedure for MD.
Purpose of the Study:
- To investigate dynamic changes in endolymphatic hydrops (EH) after EDB surgery.
- To assess long-term surgical outcomes in MD patients undergoing EDB.
- To evaluate the impact of endolymphatic sac morphology on EDB efficacy.
Main Methods:
- Retrospective analysis of 33 refractory MD patients who underwent EDB.
- Patients classified into normal-type (n=14) and atrophic-type (n=19) ES groups.
- Comparison of vertigo, hearing, vestibular function, and MRI findings pre- and post-surgery.
Main Results:
- The normal-type ES group showed significantly better vertigo control, cochlear/vestibular function, and lower endolymph volume compared to the atrophic-type group (P<0.05).
- Reversal of EH occurred in 7 normal-type patients, but not in the atrophic-type group.
- Surgical outcomes for EDB varied based on ES morphology.
Conclusions:
- EDB treatment response differs between normal and atrophic endolymphatic sac types in MD patients.
- ES morphology may indicate distinct underlying disease mechanisms in Ménière's disease.
- Further research is needed to understand the implications of ES pathology for EDB treatment effectiveness.
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