Endolymphatic sac surgery for refractory luetic vertigo

The clinical symptoms of otitic syphilis, either congential or acquired, are indistinguishable from Meniere's disease. In most cases the symptoms can be controlled by long-term and intensive medical treatment with penicillin and steroids. However, in some cases, luetic vertigo is refractory to such medical regimens, and surgical intervention may become necessary. We report on endolymphatic sac procedures performed on 37 patients with presumed luetic vertigo refractory to medical treatment, between March 1980 and December 1987, with follow-up ranging from 2 years to 9 years and 9 months. Results show that vertigo was completely and substantially controlled in 81 percent of cases, with 2 patients showing improvement in hearing, as assessed with AAO-HNS criteria. It is concluded that endolymphatic sac surgery is appropriate in treating refractory luetic vertigo when intensive medical therapy is unsuccessful, particularly in cases of late or tertiary-acquired lues, such as in this series.