[Dissection of endolymphatic duct in Meniere's disease].

The authors believe that endolymphatic sac (ES) surgery produces the highest and most persistent effect in comparison with all other surgical interventions in Meniere's disease (MD). Conventional views on the mechanisms underlying a beneficial effect of the ES surgery are revised and a new surgical technique is proposed. A positive effect of the operation, according to the authors, depends not on ES decompression but on the ES break taking place in separation of the dura mater from the bone skull in the outlet area of the aqueduct of the vestibule (AV). When the AV is separated from the sac, a rise in endolymphatic pressure is relieved by the endolymph pushing through the AV as it is not connected with the ES. 10 year follow-up has shown that this technique excludes subsequent endolymphatic hydrops.