The effect of endolymphatic sac excision in Menière disease

The role of the endolymphatic sac in the pathoetiology of Menière's disease has been extensively studied but remains controversial. Likewise, the mechanism behind the efficacy of the endolymphatic-mastoid shunt procedure in Menière's disease remains obscure. The central hypothesis of this study is that the endolymphatic-mastoid shunt procedure is a destructive rather than a drainage procedure. Therefore removal of the extraosseous endolymphatic sac with scarring of the intraosseous portion may be more destructive and thereby more effective in the treatment of Menière's disease than conventional shunt placement alone in the extraosseous endolymphatic sac. This study reports a 2-year follow-up on the effect of complete removal of the extraosseous endolymphatic sac for 10 patients with intractable Menière's disease and 10 matched control Menière's disease patients undergoing conventional endolymphatic-mastoid shunt surgery. This study showed no statistical difference in the change in hearing, vertigo, or disability in the two groups.