Endolymphatic mastoid shunt for treatment of Meniere's disease: a five year study.

The endolymphatic mastoid shunt seems to be an effective treatment for those patients whose Meniere's disease is refractory to medical and/or supportive treatment. This series is composed of 48 patients who were followed for up to 5 years postoperatively, with 1 year being the minimum follow-up period; 81% of these patients obtained a satisfactory relief of their vertigo. The morbidity of the procedure is low with no severe or total hearing loss reported in this series. Surgery should not be recommended until the symptoms have caused severe incapacitation; however, this delay must be tempered by the desire to operate while the hearing is still fluctuating. One of the most important factors in the surgical success may be the exact identification and exposure of the sac at the time of surgery, regardless of the specific shunt technique used. Shorter duration of symptoms and lack of fluctuant hearing loss may be preoperative factors which predict a less satisfactory surgical result. While the endolymphatic shunt procedure is effective in the majority of cases, the patient should be prepared for a secondary procedure if necessary.