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[Endolymphatic sac drainage and steroid-instillation surgery (EDSS) for intractable Meniere's disease].

Abstract
Endolymphatic sac surgery is one of the most widely accepted techniques used to treat intractable Meniere's disease. To improve this surgery, we developed the following techniques: A simple mastoidectomy was used to expose the endolymphatic sac between the sigmoid sinus and inferior margin of the posterior semicircular canal. The sac was opened and filled with a mass of prednisolone. A bundle of absorbable gelatin films was then inserted into the sac lumen to expand it, followed by gelatin sponges dipped in a high concentration of dexamethasone. Long-term results (17-32 months) in 20 patients with intractable Meniere's disease treated with endolymphatic sac drainage and steroid-insertion surgery (EDSS) showed that definitive spells were completely controlled in 15 of 20 cases (75%); all reports of vertigo decreased; hearing improved in 12 of 20 cases (60%); and annoyance due to tinnitus decreased in 15 of 20 cases (75%). Steroids directly instilled into the endolymphatic cavity may thus be more effective with the diseased inner ear organs than those applied via any other route. Draining of endolymphatic fluid at the sac into the mastoid cavity also contributed to these satisfactory EDSS results.
AuthorsT Kitahara, N Takeda, K Kondoh, T Morihana, S Okumura, Y Mishiro, M Fukushima, T Kubo
JournalNihon Jibiinkoka Gakkai kaiho (Nihon Jibiinkoka Gakkai Kaiho) Vol. 104 Issue 7 Pg. 728-34 (Jul 2001) ISSN: 0030-6622 [Print] Japan
PMID11524824 (Publication Type: Clinical Trial, English Abstract, Journal Article, Research Support, Non-U.S. Gov't)
Chemical References
  • Anti-Inflammatory Agents
  • Prednisolone
Topics
  • Adult
  • Anti-Inflammatory Agents (administration & dosage)
  • Drainage (methods)
  • Endolymphatic Sac (surgery)
  • Endolymphatic Shunt (methods)
  • Female
  • Humans
  • Instillation, Drug
  • Male
  • Meniere Disease (therapy)
  • Middle Aged
  • Prednisolone (administration & dosage)
  • Treatment Outcome

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