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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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