The effect of surgical removal of the extraosseous portion of the endolymphatic sac in patients suffering from Menière's disease.

Between April 1990 and June 1996, the extraosseous portion of endolymphatic sac has been removed from the affected ear in 77 patients suffering from Menière's disease. Removal of the extraosseous part of the endolymphatic sac without any drainage procedure did not increase the frequency or severity of the attacks of vertigo in any patient. The results of 43 patients with unilateral disease who had a follow-up period of two years are presented. Only eight of the patients had more than two recurrent attacks of vertigo lasting over two minutes within the two years after the surgery, and in three of these patients the severity of the attacks was greatly reduced. In 56 per cent of the operated ears, the hearing deteriorated at least 10 dBHL across five audiometric frequencies (250 Hz, 500 Hz, 1 kHz, 2 kHz and 3 kHz). To the author, endolymphatic sac removal appeared to provide better relief from vertigo than a simple drainage procedure with less tendency for recurrence several months or years after the initial surgery. At present, the statistical analysis of the results shows no significant difference between removal of the extraosseous portion of the endolymphatic sac and the "so called' endolymphatic sac drainage procedures.