title: Sac surgery results as a function of preoperative distress level.
abstract: OBJECTIVE
  To evaluate the postoperative status of the patients after endolymphatic sac decompression (ESD) for intractable unilateral definite Ménière's disease (MD) using the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) 1995 criteria and to discuss the current status of ESD in the management of MD, especially after the wide use of intratympanic administration of gentamicin for the treatment of intractable MD.
  
  
  METHODS
  Retrospective questionnaire-based analysis.
  
  
  METHODS
  Thirty-nine patients who had undergone ESD between 1996 and May 2003 at Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India, were evaluated via a set format according to AAO-HNS 1995 guidelines. Their preoperative and postoperative data were compared.
  
  
  RESULTS
  We found significant improvement in functional level scales (FLSs) in 84.6%, Class A vertigo control in 82%, and improved disability outcome in 87% of cases after surgery at a median postoperative follow-up of 29 months. All the patients showing significant improvement in FLS were preoperatively in scale 4 or more, and all the patients whose treatment failed were in scale 3 or less.
  
  
  CONCLUSIONS
  We recommend continued use of ESD in indicated patients. We found a positive relation between preoperative distress level of the patient and postoperative improvement in FLSs; any such relationship should be investigated with a larger sample.
authors.affiliation: Neuro-Otology Unit, Department of Neuro-Surgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, India.
authors.forename: Isha
authors.initials: I
authors.lastname: Tyagi
authors.forename: Amit
authors.initials: A
authors.lastname: Goyal
authors.forename: Rajan
authors.initials: R
authors.lastname: Syal
mesh_terms: D000328:Adult; D019299:Decompression, Surgical / Q000379:methods*; D004712:Endolymphatic Sac / Q000601:surgery*; D005260:Female; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000601:surgery*; D008875:Middle Aged; D011182:Postoperative Care; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome