The subarachnoid shunt for Menière's disease: sixteen years' experience.

One hundred forty patients have been treated at the Baptist Memorial Hospital in Memphis, Tennessee for Menière's disease over a 16-year period, using an endolymphatic sac-subarachnoid shunt. Emphasis was placed on surgical methods, including compression of the sigmoid sinus with bone wax during surgery, facial nerve identification, and coverage of the sac with vein tissue. Satisfactory follow-up was accomplished in 66% of patients. Results were reported according to the criteria of the American Academy of Ophthalmology and Otolaryngology (1972). Control of attacks was accomplished in 83% of cases; median pure tone average (PTA) was 49 dB preoperatively and 54 dB postoperatively. Speech discrimination was 78% preoperatively and 69% postoperatively. Sixty-eight patients (51%) were graded as class A or B. Sixty-six (49%) were class C or D. Twenty-three patients (17%) were A+. Absence of nasal allergy and the presence of fluctuation of hearing appeared to indicate a more favorable outcome.