CC BY-NC-ND 4.0 · Int Arch Otorhinolaryngol 2017; 21(02): 179-183
DOI: 10.1055/s-0037-1599276
Systematic Review – The Surgical Management of Vestibular Disorders
Thieme-Revinter Publicações Ltda Rio de Janeiro, Brazil

Endolymphatic Sac Surgery for Ménière's Disease – Current Opinion and Literature Review

Maria de Lourdes Flores García
1   Otorhinolaryngology Department, Grupo Otológico Médica Sur, México, DF, Mexico
,
Carolina de la Llata Segura
1   Otorhinolaryngology Department, Grupo Otológico Médica Sur, México, DF, Mexico
,
Juan Carlos Cisneros Lesser
2   Otorhinolaryngology and Neurotology Department, Instituto Nacional de Rehabilitación, México, DF, Mexico
,
Carlo Pane Pianese
3   Otorhinolaryngology and Neurotology, Grupo Otológico Médica Sur, Neurociencias Clínicas e Investigación, Ciudad de México, DF, Mexico
› Author Affiliations
Further Information

Publication History

02 December 2016

01 February 2017

Publication Date:
31 March 2017 (online)

Abstract

Introduction The endolymphatic sac is thought to maintain the hydrostatic pressure and endolymph homeostasis for the inner ear, and its dysfunction may contribute to the pathophysiology of Ménière's disease. Throughout the years, different surgical procedures for intractable vertigo secondary to Ménière's disease have been described, and though many authors consider these procedures as effective, there are some who question its long-term efficacy and even those who think that vertigo control is achieved more due to a placebo effect than because of the procedure itself.

Objective To review the different surgical procedures performed in the endolymphatic sac for the treatment of Ménière's disease.

Data Sources PubMed, MD consult and Ovid-SP databases.

Data Synthesis We focus on describing the different surgical procedures performed in the endolymphatic sac, such as endolymphatic sac decompression, endolymphatic sac enhancement, endolymphatic sac shunting and endolymphatic duct blockage, their pitfalls and advantages, their results in vertigo control and the complication rates. The senior author also describes his experience after 30 years of performing endolymphatic sac surgery.

Conclusions The endolymphatic sac surgery, with all its variants, is a good option for patients with incapacitating endolymphatic hydrops, providing a high percentage of vertigo control and hearing preservation.

 
  • References

  • 1 Snow Jr JB, Kimmelman CP. Assessement of surgical procedures for Ménière's disease. Laryngoscope 1979; 89 (5 Pt 1): 737-747
  • 2 Durland Jr WF, Pyle GM, Connor NP. Endolymphatic sac decompression as a treatment for Meniere's disease. Laryngoscope 2005; 115 (08) 1454-1457
  • 3 Brinson GM, Chen DA, Arriaga MA. Endolymphatic mastoid shunt versus endolymphatic sac decompression for Ménière's disease. Otolaryngol Head Neck Surg 2007; 136 (03) 415-421
  • 4 Thomsen J, Bretlau P, Tos M, Johnsen NJ. Placebo effect in surgery for Ménière's disease. A double-blind, placebo-controlled study on endolymphatic sac shunt surgery. Arch Otolaryngol 1981; 107 (05) 271-277
  • 5 Thomsen J, Bretlau P, Tos M, Johnsen NJ. Endolymphatic sac-mastoid shunt surgery. A nonspecific treatment modality?. Ann Otol Rhinol Laryngol 1986; 95 (1 Pt 1): 32-35
  • 6 Bretlau P, Thomsen J, Tos M, Johnsen NJ. Placebo effect in surgery for Menière's disease: nine-year follow-up. Am J Otol 1989; 10 (04) 259-261
  • 7 Portmann G. The saccus endolinphaticus and the operation for draining the same for relief of vertigo. J Laryngol Otol 1927; 42: 809-817
  • 8 Portamann G. Surgical Treatment of vertigo by opening of the saccus endolymphaticus. Arch Otolaryngol 1969; 89 (06) 809-815
  • 9 Hallpike CS, Cairns H. Observation on pathology of Ménière's syndrome. J Laryngol Otol 1938; 53: 624-654
  • 10 House WF. Subarachnoid shunt for drainage of endolymphatic hydrops. A preliminary report. Laryngoscope 1962; 72: 713-729
  • 11 Kimura RS. Experimental Blockage of the endolymphatic duct and sac and its effects on the inner ear of the guinea pig. Ann Otol Rhinol Laryngol 1967; 76 (03) 4664-4687
  • 12 Paparella MM, Hanson DG. Endolymphatic sac drainage for intractable vertigo (method and experiences). Laryngoscope 1976; 86 (05) 697-703
  • 13 Paparella MM, Goycoolea M. Panel of Menière's disease. Endolymphatic sac enhancement surgery for Menière's disease: an extension of conservative therapy. Ann Otol Rhinol Laryngol 1981; 90 (6 Pt 1): 610-615
  • 14 Brown JS. A ten year statistical follow-up of 245 consecutive cases of endolymphatic shunt and decompression with 328 consecutive cases of labyrinthectomy. Laryngoscope 1983; 93 (11 Pt 1): 1419-1424
  • 15 Söderman AC, Ahlner K, Bagger-Sjöbäck D, Bergenius J. Surgical treatment of vertigo--the Karolinska Hospital policy. Am J Otol 1996; 17 (01) 93-98
  • 16 Convert C, Franco-Vidal V, Bebear JP, Darrouzet V. Outcome-based assessment of endolymphatic sac decompression for Ménière's disease using the Ménière's disease outcome questionnaire: a review of 90 patients. Otol Neurotol 2006; 27 (05) 687-696
  • 17 Goto F, Tsutsumi T, Ogawa K. Lateral semicircular canal plugging with endolymphatic sac decompression as new surgical treatment for intractable Meniere's disease. Acta Otolaryngol 2012; 132 (08) 893-895
  • 18 Kim SH, Ko SH, Ahn SH, Hong JM, Lee WS. Significance of the development of the inner ear third window effect after endolymphatic sac surgery in Ménière disease patients. Laryngoscope 2012; 122 (08) 1838-1843
  • 19 Sood AJ, Lambert PR, Nguyen SA, Meyer TA. Endolymphatic sac surgery for Ménière's disease: a systematic review and meta-analysis. Otol Neurotol 2014; 35 (06) 1033-1045
  • 20 Brookes GB. Circulating immune complexes in Meniere's disease. Arch Otolaryngol Head Neck Surg 1986; 112 (05) 536-540
  • 21 Alleman AM, Dornhoffer JL, Arenberg IK, Walker PD. Demonstration of autoantibodies to the endolymphatic sac in Meniere's disease. Laryngoscope 1997; 107 (02) 211-215
  • 22 Shea Jr JJ. The role of dexamethasone or streptomycin perfusion in the treatment of Meniere's disease. Otolaryngol Clin North Am 1997; 30 (06) 1051-1059
  • 23 Sennaroglu L, Sennaroglu G, Gursel B, Dini FM. Intratympanic dexamethasone, intratympanic gentamicin, and endolymphatic sac surgery for intractable vertigo in Meniere's disease. Otolaryngol Head Neck Surg 2001; 125 (05) 537-543
  • 24 Garduño-Anaya MA, Couthino De Toledo H, Hinojosa-González R, Pane-Pianese C, Ríos-Castañeda LC. Dexamethasone inner ear perfusion by intratympanic injection in unilateral Ménière's disease: a two-year prospective, placebo-controlled, double-blind, randomized trial. Otolaryngol Head Neck Surg 2005; 133 (02) 285-294
  • 25 Kitahara T, Kubo T, Okumura S, Kitahara M. Effects of endolymphatic sac drainage with steroids for intractable Meniere's disease: a long-term follow-up and randomized controlled study. Laryngoscope 2008; 118 (05) 854-861
  • 26 Giddings NA, Shelton C, O'Leary MJ, Brackmann DE. Cochleosacculotomy revisited. Long-term results poorer than expected. Arch Otolaryngol Head Neck Surg 1991; 117 (10) 1150-1152
  • 27 Hu A, Parnes LS. 10-year review of endolymphatic sac surgery for intractable meniere disease. J Otolaryngol Head Neck Surg 2010; 39 (04) 415-421
  • 28 Teufert KB, Doherty J. Endolymphatic sac shunt, labyrinthectomy, and vestibular nerve section in Meniere's disease. Otolaryngol Clin North Am 2010; 43 (05) 1091-1111
  • 29 Soheilipour S, Abtahi SH, Soltani M, Khodadadi HA. Comparison the results of two different vestibular system surgery in patients with persistent Meniere's disease. Adv Biomed Res 2015; 4: 198-07
  • 30 Gabra N, Asmar MH, Berbiche D, Saliba I. Endolymphatic duct blockage: quality of life assessment of a novel surgical technique for Ménière disease. Eur Arch Otorhinolaryngol 2016; 273 (10) 2965-2973 ; [Epub ahead of print ]
  • 31 Saliba I, Gabra N, Alzahrani M, Berbiche D. Endolymphatic duct blockage: a randomized controlled trial of a novel surgical technique for Ménière's disease treatment. Otolaryngol Head Neck Surg 2015; 152 (01) 122-129
  • 32 Locke RR, Shaw-Dunn J, O'Reilly BF. Endolymphatic sac surgical anatomy and transmastoid decompression of the sac for the management of Ménière's disease. J Laryngol Otol 2014; 128 (06) 488-493
  • 33 Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menière's disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc. Otolaryngol Head Neck Surg 1995; 113 (03) 181-185
  • 34 Chia SH, Gamst AC, Anderson JP, Harris JP. Intratympanic gentamicin therapy for Ménière's disease: a meta-analysis. Otol Neurotol 2004; 25 (04) 544-552
  • 35 Huang TS. Endolymphatic sac surgery for Meniere's disease: experience with over 3000 cases. Otolaryngol Clin North Am 2002; 35 (03) 591-606
  • 36 Bento RF, Cisneros JC, De Oliveira Fonseca AC. Endolymphatic sac drainage for the treatment of Ménière's disease. J Laryngol Otol 2016; 1-6 [ Epub ahead of print ]
  • 37 Silverstein H, Smouha E, Jones R. Natural history vs. surgery for Menière's disease. Otolaryngol Head Neck Surg 1989; 100 (01) 6-16