Sac decompression for refractory luetic vertigo.

Luetic hydrops can occur in both congenital and acquired lues and otologic manifestations may be indistinguishable from Meniere's disease. Eight endolymphatic sac decompression procedures were performed on 6 patients with refractory luetic vertigo. Of those, 3 had congenital and 3 acquired lues. All cases had received extensive anti-luetic medical therapy without any discernible improvement in the vertiginous attacks. In our 6 patients with luetic hydrops the main complaint was severe refractory vertigo, indeed, disabling in most cases. Postoperatively, all cases remained free from these severe attacks and the vertigo was controlled or eliminated in all cases. Although hearing was improved in one patient, hearing seemed not to improve, generally speaking, as a result of the long-term postoperative follow-up. We describe our method of sac decompression and drainage and suggest that this procedure might be considered for patients with uncontrollable luetic vertigo who have not benefited from adequate medical therapy.