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Role and results of cortical mastoidectomy and endolymphatic sac surgery in Menière's disease

Published online by Cambridge University Press:  29 June 2007

A. G. Kerr ,
J. G. Toner ,
G. J. McKee  and
G. D. L. Smyth
A. G. Kerr*
Affiliation:
Belfast
J. G. Toner
Affiliation:
Belfast
G. J. McKee
Affiliation:
Belfast
G. D. L. Smyth
Affiliation:
Belfast
*
A. G. Kerr FRCS, Consultant ENT Surgeon, Eye and Ear Clinic, Royal Victoria Hospital, Belfast BT12 6BANorthern Ireland
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Abstract

It is almost impossible to establish the natural history of Menière's disease and, by the same token, it is difficult to confirm the efficacy of endolymphatic sac surgery. The authors doubt the logic of sac operations. Only two controlled trials of sac surgery have been found and both cast doubt upon its value. There do not appear to be any controlled trials indicating that it works.

In 14 cases of incapacitating Menière's disease, where vestibular nerve section was indicated, cortical mastoidectomy was offered and accepted in the expectation that two-thirds might be spared the more major procedure. In the event, the vertigo was controlled in eight out of 14 (57 per cent), the remaining six (43 per cent) requiring more major surgery.

A surgical model illustrates that, of themselves, these results are essentially meaningless in assessing the efficacy of cortical mastoidectomy in Menière's disease. Until all cases in a community are considered and followed-up, we shall be in doubt about the value of sac surgery and most other treatments of Menière's disease.

Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 103 , Issue 12 , December 1989 , pp. 1161 - 1166
Copyright
Copyright © JLO (1984) Limited 1989

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References

Alford, B. R. (1972). Menière's disease: criteria for diagnosis and evaluation of therapy for reporting. Transactions of the American Academy of Ophthalmology and Otolaryngology, 76: 1462–1464.Google Scholar
Austin, D. F. (1984). Endolymphatic fistulization. Annals of Otology, Rhinology and Laryngology, 93: 534–539.CrossRefGoogle ScholarPubMed
Bretlau, P., Thomsen, J., Tos, M., and Johnsen, N. J. (1984). Placebo effects in surgery for Menière's disease: a three-year follow-up of patients in a double-blind, placebo controlled study on endolymphatic sac shunt surgery. American Journal of Otology, 5: 558–561.Google Scholar
Goldenberg, R. A., and Justus, M. A. (1983). Endolymphatic mastoid shunt for treatment of Menière's disease: a five year study. Laryngoscope, 93: 1425–1429.CrossRefGoogle ScholarPubMed
Hallpike, C. S., and Cairns, H. (1938). Observations on the pathology of Menière's syndrome. Journal of Laryngology and Otology, 53: 625–655.CrossRefGoogle Scholar
Kitahara, M., and Kitano, H. (1985). Surgical treatment of Menière's disese. American Journal of Otology, 6: 108–109.Google Scholar
Pearson, B. W. and Brackmann, D. E. (1985). Committee on Hearing and Equilibrium guidelines for reporting treatment results in Menière's disease. Otolaryngology—Head and Neck Surgery, 93: 579–581.CrossRefGoogle ScholarPubMed
Primrose, W. J., Smyth, G. D. L., Kerr, A. G., and Gordon, D. S. (1986). Vestibular nerve section and saccus decompression: an evaluation of long-term results. Journal of Laryngology and Otology, 100: 775–784.CrossRefGoogle ScholarPubMed
Schuknecht, H. F. (1986). Endolymphatic hydrops: can it be controlled? Annals of Otology, Rhinology and Laryngology 95: 36–39.CrossRefGoogle ScholarPubMed
Silverstein, H., Smouha, E., and Jones, R. (1989). Natural history vs surgery for Menière's disease. Otolaryngology Head and Neck Surgery, 100: 6–16.CrossRefGoogle ScholarPubMed
Thomsen, J., Bretlau, P., Tos, M., and Johnsen, N. J. (1981). Placebo effect in surgery for Menière's disease. Archives of Otolaryngology 107: 271–277.CrossRefGoogle Scholar
Thomsen, J., Bretlau, P., Tos, M., and Johnsen, N. J. (1986). Endolymphatic sac-mastoid shunt surgery. A nonspecific treatment modality? Annals of Otology, Rhinology and Laryngology, 95: 32–35.CrossRefGoogle ScholarPubMed
Wiet, R. J., Kazan, R., and Shambaugh, G. E. (1981). An holistic approach to Menière's disease. Medical and surgical management. Laryngoscope, 91: 1647–1662.CrossRefGoogle ScholarPubMed