title: Histopathology after endolymphatic sac surgery for Ménière's syndrome.
abstract: BACKGROUND
  The putative goal of sac surgery in Ménière's syndrome is to promote the flow of endolymph from the labyrinth to the endolymphatic sac and thereby relieving hydrops. There are scant published histopathologic data whether sac surgery actually accomplishes this goal.
  
  
  OBJECTIVE
  To determine whether sac surgery relieves hydrops by examining the histopathologic changes in temporal bones obtained from individuals who had undergone sac surgery during life for Ménière's syndrome.
  
  
  METHODS
  Temporal bones were examined from 15 patients who had sac surgery. Data on the presence and severity of hydrops, histology of the sac, and whether the procedure relieved vertigo were collected.
  
  
  RESULTS
  The surgery failed to expose the sac in 5 cases; 4 of the 5 had relief from vertigo. The sac was exposed, but the shunt failed to reach the lumen of the sac in 8 cases; 4 of the 8 had relief from vertigo. The shunt was successfully placed within the lumen of the sac in 2 cases; both cases failed to experience relief from vertigo. Endolymphatic hydrops was present in all 15 cases.
  
  
  CONCLUSIONS
  Endolymphatic sac surgery does not relieve hydrops in patients with Ménière's syndrome. Yet, sac surgery relieves vertigo in some patients, but the mechanism of such symptomatic relief remains unknown.
authors: Massachusetts Eye and Ear and Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA.
authors: Jong Woo
authors: JW
authors: Chung
authors: Jose
authors: J
authors: Fayad
authors: Fred
authors: F
authors: Linthicum
authors: Akira
authors: A
authors: Ishiyama
authors: Saumil N
authors: SN
authors: Merchant
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018159:Endolymphatic Hydrops / Q000473:pathology* / Q000601:surgery; D004712:Endolymphatic Sac / Q000473:pathology* / Q000601:surgery; D005260:Female; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000473:pathology* / Q000601:surgery; D008875:Middle Aged; D013701:Temporal Bone / Q000473:pathology / Q000601:surgery; D016896:Treatment Outcome