Endolymphatic sac decompression and shunt placement

Abstract

Endolymphatic sac decompression and shunting is a nonablative surgical option for patients with intractable Meniere's disease. Sac surgery had a high success rate for vertigo control in this population with 75%-95% of patients experiencing improvement or resolution of their vertigo spells. The addition of high-dose steroid instillation into the sac has demonstrated improved vertigo rates. The risk of complications is low but includes hearing loss, persistent vestibular dysfunction, cerebrospinal fluid (CSF) leak or facial nerve injury. Decompression or shunt placement should be considered for all patients who fail dietary and medical therapies before considering ablative treatments. © 2019