Results of endolymphatic sac to mastoid shunt surgery for Menière's disease refractory to medical therapy.

Abstract

In the ten-year period ending July 1, 1986, 5475 dizzy patients were evaluated and treated medically at the Colorado Ear Clinic. Of these, 214 patients (4%) were diagnosed as having classic Meniere's disease refractory to medical therapy and underwent endolymphatic sac to mastoid shunt surgery. These patients were followed for a minimum of one year after surgery. The average audiometric follow-up was 35.1 months. Based on the American Academy of Otolaryngology-Head and Neck Surgery 1985 criteria for reporting results at one year, 60.3% had lower audiometric thresholds postoperatively (H1) or unchanged thresholds (H2) relative to the worst preoperative audiogram. Elimination of all vertiginous attacks was achieved in 73.9% (Vo). Adjunctive spells were not assessed. Disability was eliminated (Do) in 86%. Based on a prospective computerized analysis of forty pertinent variables, a profile of a classic Meniere's disease patient who has failed to improve with medical, allergic, dietary, exercise, or other conservative treatment and would be likely to benefit from endolymphatic sac to mastoid shunt surgery is established.