Endolymphatic fistulization.

Three previous papers have detailed my experience with various methods of surgical treatment of Meniere's disease: 1) surgery for all patients; 2) surgery for only those patients who demonstrated patency of the vestibular aqueduct as seen on tomographic examination; and 3) prognostic tests to determine which patients were most suitable for endolymphatic sac surgery. This paper details the results of endolymphatic shunt surgery performed on 43 patients over a 3-year period, restudying my prior conclusions. All patients were operated using a new method of capillary endolymph dispersement regardless of tomographic findings. The results are compared to the results of the prior studies to determine whether the findings of tomography are correlated with success or failure of shunt operations, a conclusion that others have questioned. This study clearly shows that the present technique affords better results than prior methods regardless of the x-ray findings. In addition, the tomographic findings correlate closely to the clinical pattern of the disease and to the success or failure of the operation.