The Status of Endolymphatic Sac Surgery

  • Masaaki Kitahara


Otologists who have no prior experience with Ménière’s disease surgery must review the literature in order to decide upon the suitable technique for the case of the disease at hand. Until now, a wide variety of literature concerning modified techniques has appeared, suggesting that there seems to be no single technique which has satisfied any one surgeon. In most critical papers, the efficacy of conservative surgery, such as endolymphatic sac surgery on Ménière’s disease, has been described as questionable because no significant difference from medical treatment has been observed. There was even an experiment indicating that the efficacy of an active operation to be the same as that of a placebo operation [1]. Is conservative surgery, then, really not effective for Ménière’s disease? Additionally, is destructive surgery more preferable than nondestructive conservative surgery? In this paper, I will describe our policy of surgical treatment for Ménière’s disease derived from 20 years of experience, primarily with intra-mastoid drainage surgery.


Mastoid Cavity Endolymphatic Hydrops Cochlear Duct Vestibular Aqueduct Drainage Surgery 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Thomsen J. Bretlau P (1986) General conclusion. In: Pfaltz CR (ed) Controversial aspects of Ménierè’s disease. Georg Thieme, Stuttgart, pp. 120–136Google Scholar
  2. 2.
    Kitahara M (1971) Surgical treatment of Ménierè’s disease (in Japanese). Pract Otol (Kyoto) 64: 349–369Google Scholar
  3. 3.
    Kitahara M, Matsubara H, Takeda T, Yazawa Y (1979) Bilateral Ménierè’s disease. Adv Otorhinolaryngol 25: 117–121PubMedGoogle Scholar
  4. 4.
    Day KM (1943) Labyrinthine surgery for Ménierè’s disease. Laryngoscope 53: 617–630CrossRefGoogle Scholar
  5. 5.
    Arslan M (1953) Treatment of Ménierè’s syndrome by direct application of ultrasound waves to the vestibular system. In: Proceedings of the international congress of otolaryngology, Amsterdam, pp. 429–436Google Scholar
  6. 6.
    Wolfson RJ (1966) Cryosurgery of the labyrinth. Laryngoscope 76: 733–753PubMedCrossRefGoogle Scholar
  7. 7.
    Kitahara M, Kitajima K, Yazawa Y, Uchida K (1987) Endolymphatic sac surgery for Ménierè’s disease: Eighteen-year experience with the Kitahara sac operation. Am J Otol 4: 283–286Google Scholar
  8. 8.
    Portmann G (1927) Vertigo: Surgical treatment by opening the saccus endolymphaticus. Arch Otolaryngol 6: 309–319Google Scholar
  9. 9.
    Fick IA (1965) Sacculotomy for hydrops. Laryngoscope 75: 1531–1546Google Scholar
  10. 10.
    Cody DTR (1967) Automatic repetitive decompression of the saccule in endolymphatic hydrops. Laryngoscope 77: 1480–1501PubMedCrossRefGoogle Scholar
  11. 11.
    Pulec JL (1968) The otoperotic shunt. In: Pulec JL (ed) Ménierè’s disease. Saunders, Phil adelphia, pp 643–648Google Scholar
  12. 12.
    Kitahara M, Takeda T, Yazawa Y, Matsubara H, Kitano H (1982) Experimental study on Ménierè’s disease. Otolaryngol Head Neck Surg 90: 470–481PubMedGoogle Scholar
  13. 13.
    Kitahara M, Takeda T, Yazawa Y, Matsubara H (1980) Surgical confirmation of endolymphatic hydrops by hearing gain by bone conduction. In: Proceedings of the 6th Shambaugh international workshop on microsurgery and the 3rd Shea fluctuating hearing loss symposium. Strode, Huntsville, pp 260–263Google Scholar
  14. 14.
    Yamakawa K, Naito T (1954) The modification of Portmann’s operation for Ménierè’s disease (in Japanese). Med J Osaka University 5: 167–175Google Scholar
  15. 15.
    House WF (1962) Subarachnoid shunt for drainage of endolymphatic hydrops. Laryngoscope 72: 713–729PubMedGoogle Scholar
  16. 16.
    Weille FL, O’Brien HF (1958) Pressures of the labyrinthine fluids. Ann Otol Rhinol Laryngol 67: 858PubMedGoogle Scholar
  17. 17.
    Kitahara M, Futaki T, Morimoto M (1974) Epidural drainage operation for Ménierè’s disease (in Japanese). Equilibrium Res 4: 48–51Google Scholar
  18. 18.
    Kitahara M, Takeda T, Yazawa Y, Matsubara H (1983) Experimental and clinical studies on epidural drainage surgery. Adv Otorhinolaryngol 30: 242–244PubMedGoogle Scholar
  19. 19.
    Kitahara M, Kitano H (1985) Surgical treatment of Ménierè’s disease. Am J Otol 6: 108–109PubMedGoogle Scholar
  20. 20.
    Kithahara M, Kitajima K (1988) Intramastoid drainage surgery for Ménierè’s disease—Critical analysis of variation of surgical results for Ménierè’s disease. Adv Otorhinolaryngol 42: 269–274Google Scholar

Copyright information

© Springer-Verlag Tokyo 1990

Authors and Affiliations

  • Masaaki Kitahara

There are no affiliations available

Personalised recommendations