SAC-VEIN DECOMPRESSION FOR INTRACTABLE MENIERES-DISEASE - 2-YEAR TREATMENT RESULTS

Surgical intervention has been offered to patients with Meniere's dise ase who have failed medical treatment and have disabling symptoms, Sur gical options have included labyrinthectomy (mechanical and chemical), vestibular neurectomy, and endolymphatic sac surgery with or without shunting. We present a modification of endolymphatic sac decompression surgery that includes wide decompression of the sigmoid sinus, poster ior cranial fossa dura, and endolymphatic sac (sac-vein decompression) , Thirty-five patients underwent 37 primary procedures with 2 years of follow-up, Patients were evaluated according to the 1985 American Aca demy of Otolaryngology-Head and Neck Surgery criteria for assessing Me niere's disease, Vestibular symptom severity was resolved or mild in 9 2% and disability severity was none or mild in 95% of patients at 2 ye ars after surgery, Vertigo control was complete or substantial in 85% and 100% of patients at 1 and 2 years after surgery. Audiologic data s howed stable or improved hearing in 86% and 85% of patients at 1 and 2 years offer surgery. In summary, wide decompression of the sigmoid si nus, posterior cranial fossa dura, and endolymphatic sac offers improv ed control of vertigo and hearing stabilization for intractable Menier e's disease compared with simple endolymphatic sac decompression or sh unt surgery.