Endolymphatic sac surgeries in Meniere’s disease

Endolymphatic sac surgeries in Meniere’s disease
Sh. Nemati

Surgery on the endolymphatic sac for the control of vertigo in Meniere’s disease dates back to 1927(Portman). Endolymphatic sac surgery has been a favorable option for medically refractory Meniere’s disease, as it is a hearing preservation surgery and has low morbidity. It has been performed with several variations: sac shunting, sac drainage, and sac decompression (ESD) with or without wide decompression of the posterior cranial fossa dura or sigmoid sinus decompression. Recently, endolymphatic duct blockage (EDB) has been proposed as a novel surgical technique for the treatment of Meniere’s disease. Although ESD is the most common surgical procedure for the disease, the effectiveness of these surgeries has been debated. In this lecture, we review the indications, techniques, complications, and controversies of endolymphatic sac surgeries in Meniere’s disease.