Jens Thomsen, P.Bonding, B.Becker, J. Stage, M.Tos

ENT departments, Gentofte and Glostrup University Hospitals,

2900 Hellerup, Denmark.

Meniere's Disease: The non-spesific effect of endolymphatic sac surgery. A comparison of the therapeutic effect of an endolymphatic Sac shunt and a ventilating tube in the tympanic membrane.

In 1981 we published the results of a double blind randomized study of the effect of a regular endolymphatic sac shunt and a cortical mastoidectomy upon the symptoms of Meniere's patients, and concluded that both treatment modalities significantly reduced the symptoms, and that the effect of a regular sac operation was at best non-specific.

We have now performed a similar study, where the effect of a sac shunt was compared to the effect of insertion of a ventilating tube in the tympanic membrane. 15 patients had a regular shunt inserted and 14 patients a ventilating tube. Both groups were operated under general anesthesia, with normal intubation, and the randomization was not made until the patient was intubated and surgically draped.

The results were un-equivocal: With regard to the vestibular symptoms both groups improved significanty, using the reporting system of the AAOO, 1995, while tinnitus and hearing ability was unchanged, and there was no difference between the regular sac insertion and insertion of a ventilating tube in the tympanic membrane. While one could elaborate upon the physiological explanation for the effect of a ventilation tube in the tympanic membrane we find, that the effect of endolymphatic sac surgery is still unexplained and should be described as non-specific.