A further critical assessment of the efficacy of endolymphatic sac surgery

This paper further assesses the efficacy of two selected techniques of endolymphatic sac surgery (ELS) employing implants for the treatment of classic Meniere's disease and endolymphatic hydrops: the Arenberg inner ear valve implant and the newly developed Huang/Gibson inner ear shunt. Long-term (8-10 years) results for 57 patients given the Arenberg inner ear valve implant show that our demonstrated high success rate in achieving control of symptoms over the short term (1 year) is long-lasting and that although previously reported hearing gains have decreased in some cases, the overall long-term hearing results are better than for other surgical techniques. Preliminary results (less than 1 year) for 10 patients treated with the Huang/Gibson inner ear shunt indicate that it is comparable in efficacy to the Arenberg implant, while 4 out of the 10 patients have shown remarkable hearing gain, as detailed in case reports. These results again illustrate and substantiate the authors' previous conclusion that, in cases where there is a definitive delineation of the endolymphatic sac and its lumen, and where the sac is anatomically suitable, ELS is undoubtedly an effective modality and should be the standard primary choice for intractable Meniere's disease.