Revision endolymphatic sac and duct surgery for recurrent Meniere's disease and hydrops: failure analysis and technical aspects.

Endolymphatic system surgery for Meniere's disease has been shown to be effective in selected cases; however, some patients do not achieve substantial long-term relief from their symptoms in spite of early success and may require revision surgery. Revision endolymphatic system surgery has been reported in the literature in 9.7% to 16.3% of patients. As part of an ongoing prospective analysis of endolymphatic valve implant surgery, the first 400 procedures performed over 6 years were analyzed to determine the rate and cause for revision surgery. Fifty-four of 386 (13.9%) of endolymphatic valve implants performed by the authors required revision. Fourteen cases initially operated on elsewhere are also analyzed. The most frequent causes of failure was outflow tract obstruction caused by temporalis fascia, previously used to anchor the valve. Since that technique has been abandoned, the revision rate of primary valve implants is 6.7%.