http://www.ncbi.nlm.nih.gov/pubmed/25403881 Endolymphatic Duct Blockage: A Randomized Controlled Trial of a Novel Surgical Technique for Ménière's Disease Treatment. Saliba I1, Gabra N2, Alzahrani M2, Berbiche D3. Author information Abstract OBJECTIVES: To compare the effectiveness of the endolymphatic duct blockage (EDB) and the endolymphatic sac decompression (ESD) to control Ménière's disease symptoms and to evaluate their effect on hearing level. STUDY DESIGN: Prospective nonblinded randomized study. SETTING: Tertiary medical center. SUBJECTS AND METHODS: Fifty-seven patients affected by a refractory Ménière's disease were included out of which 22 underwent an ESD and 35 underwent an EDB. Five periods of follow-up were considered: 0 to 1 week, 1 week to 6 months, 6 to 12 months, 12 to 18 months, and 18 to 24 months. Mean outcome measurements consisted of vertigo control, tinnitus, aural fullness, instability, and hearing level. Hearing level was evaluated using pure-tone average (PTA) and speech discrimination score (SDS). RESULTS: There was no significant difference between the 2 groups in the number of vertigo spells per months preoperatively (P = .153). Twenty-four months postoperatively, 96.5% of the EDB group had achieved a complete control of vertigo spells against 37.5% of the ESD group with a statistically significant difference (P = .002). There was a better control of tinnitus and aural fullness with EDB (P = .021 and P = .014, respectively). There was no statistically significant difference in hearing level preoperatively (P = .976) and 24 months postoperatively (P = .287) between the 2 groups. Hearing level was preserved in each group with no significant difference between the preoperative and the postoperative levels (P > .05). CONCLUSION: EDB is more effective than the traditional ESD in controlling the symptoms of Ménière's disease. It is a novel surgical technique with promising results for a complete treatment of Ménière's disease. There are no significant complications or adverse effect. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2014.
And a January 2015 study! Very recent. i had heard that some doctors were looking into the valve of Bath (sp) as the key to unlocking this shit.
Thanks BD, it sounds like a good option for those who do not respond to antivirals or other MM treatments.
I had the Endolymphatic shunt surgery in 2012. After about 3 weeks (and having only a couple of vertigo episodes), I no longer have the vertigo! I do have daily feeling of lightheadedness/dizziness/head pressure! The hearing has not improved but has not lessened either. I have some balance issues--obviously (see my post on recent fall)! And have tinnitus--but not bad anymore. The dizziness and head pressure is the most significant problem I deal with these days--and it makes me 'balance challenged'!
sounds very nice the last sentence about the hope to cure it compleete in the future sounds nice realy nice.!!!!
Thanks for posting this Vicki - any idea how this procedure differs from the ESD? The name makes it sound like they're blocking up the duct that feeds fluid into the inner ear, maybe preventing the accumulation of pressure? But that's just a wild guess on my part.
you're welcome. I purchased the full artcle so I will copy and paste: Surgical Protocol of EDB First, we performed a canal wall-up mastoidectomy: the tegmen mastoideum, sigmoid sinus, and sinodural angle are identified, and the posterior bony ear canal wall is thinned. We identify the posterior semicircular canal (PSCC) and the dura matter of the posterior fossa. Using the prominence of the horizontal semicircular canal, Donaldson line is identified to approximate the position of the endolymphatic sac Bone over the sac and the dura are thinned with a diamond burrs. The sac is completely skeletonized and decompressed. The infralabyrinthine dura is exposed because the main body of the sac and its lumen often lie within this area. The sac is not incised neither dissected off the posterior fossa dura. These described parts of the surgery are performed for the 2 groups: ESD and EDB. For the ESD group, the sac is completely decompressed and the surgery is accomplished. However, for the EDB we continue to dissect the bone of the vestibular aqueduct operculum and the posterior fossa dura from the retrolabyrinthine bone medial to the sac around the endolymphatic duct in order to identify the duct in its superior and inferior part in continuity from the endolymphatic sac and create a place to insert the tips of the instrument to clip the duct. At this level care must be taken not to traumatize the dura, which is often thin. Finally we block the dissected endolymphatic duct with 2 small titanium clips (Figure 2). The titanium clips were applied by using the ligating clip applier, similar to the 1 used in vascular surgery. Statistical Analysis
