Endolymphatic duct blockage for Meniere’s Disease treatment

Abstract

An ideal treatment for Meniere’s Disease would be nonablation of the vestibular system, with a conservative effect on hearing. We have reported in January 2015 a novel surgical technique for the treatment of Meniere’s Disease—endolymphatic duct blockage (EDB)—performed as an outpatient surgical operation. It is an effective surgical nonablative technique in the event of failure of medical therapy; there is no cochlear damage clinically, and no additional vestibular damage. There is a significantly better control of the vertigo attacks when compared with the traditional endolymphatic sac decompression. We block the dissected endolymphatic duct with two small titanium clips. Postoperative wound management and postoperative care are similar to those in other mastoid surgical operation. Our hypothesis is that in Meniere’s Disease there is imbalance of the homeostasis of the endolymph at the level of the endolymphatic sac, with an increased secretion outweighing a decreased absorption resulting in an increased pressure in the inner ear. Thus, by blocking the endolymphatic duct, we decrease the volume of endolymph in the inner ear coming from the sac, which helps alleviate the symptoms of Meniere’s Disease; in absence of this result, all our patients operated by the EDB should develop a worsening of their symptoms, which is not the case. EDB operation remains a safe and effective novel procedure for the treatment of intractable Meniere’s Disease with minimal adverse effects.