Massachusetts Eye and Ear and Infirmary, Harvard Medical School, Boston, Massachusetts 02114, USA.
Otol Neurotol. 2011 Jun;32(4):660-4. doi: 10.1097/MAO.0b013e31821553ce.
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.
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.
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.
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.
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.
梅尼埃病患者鼓室手术的假定目标是促进内淋巴从迷路流向内淋巴囊，从而缓解积水。关于鼓室手术是否真的能达到这一目标，发表的组织病理学数据很少。
通过检查因梅尼埃病在生前接受过鼓室手术的个体的颞骨的组织病理学变化，确定鼓室手术是否通过缓解积水来缓解眩晕。
检查了 15 例因梅尼埃病接受鼓室手术的患者的颞骨。收集了积水的存在和严重程度、囊的组织学以及手术是否缓解眩晕的数据。
5 例手术未能暴露囊；5 例中有 4 例眩晕缓解。8 例中，有 4 例暴露了囊，但分流未能到达囊的腔；8 例中有 4 例眩晕缓解。2 例分流成功放置在囊腔内；这 2 例都没有缓解眩晕。所有 15 例均存在内淋巴积水。
内淋巴囊手术不能缓解梅尼埃病患者的积水。然而，鼓室手术在一些患者中缓解了眩晕，但这种症状缓解的机制尚不清楚。
