Endolymphatic sac surgery: why we do not do it. The non-specific effect of sac surgery

Three of the present authors described a trial in 1981 which showed that cortical mastoidectomy was as effective as an endolymphatic sac shunt in controlling vertigo in patients with Ménière's disease both on a short-term as well as a long-term basis. The hearing was not influenced by the treatment and any change was considered to be the result of time, rather than the effect of the surgery. Upon perusal of the literature only two other studies exist resembling our study, and they both reached the same conclusion, that sac surgery is at best non-specific and at worst of no value. None of the numerous other studies published have convinced the authors that sac decompression is specific in nature. We have also looked at ECoG as a means of proving the specificity of sac operations and come to the same conclusion that the existing information is conflicting and confusing, and cannot be used to prove anything about sac surgery. The present conclusion is therefore that in treating patients with Ménière's disease anything goes, even sac surgery.