Abstract
Introduction The endolymphatic sac is thought to maintain the hydrostatic pressure and endolymph
homeostasis for the inner ear, and its dysfunction may contribute to the pathophysiology
of Ménière's disease. Throughout the years, different surgical procedures for intractable
vertigo secondary to Ménière's disease have been described, and though many authors
consider these procedures as effective, there are some who question its long-term
efficacy and even those who think that vertigo control is achieved more due to a placebo
effect than because of the procedure itself.
Objective To review the different surgical procedures performed in the endolymphatic sac for
the treatment of Ménière's disease.
Data Sources PubMed, MD consult and Ovid-SP databases.
Data Synthesis We focus on describing the different surgical procedures performed in the endolymphatic
sac, such as endolymphatic sac decompression, endolymphatic sac enhancement, endolymphatic
sac shunting and endolymphatic duct blockage, their pitfalls and advantages, their
results in vertigo control and the complication rates. The senior author also describes his experience after 30 years of performing endolymphatic
sac surgery.
Conclusions The endolymphatic sac surgery, with all its variants, is a good option for patients
with incapacitating endolymphatic hydrops, providing a high percentage of vertigo
control and hearing preservation.
Keywords
endolymphatic mastoid shunt - endolymphatic sac decompression - endolymphatic sac
drainage - endolymphatic sac surgery - Ménière's disease.
