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Surgical treatment of Meniere disease via labyrinth Shunt: past and present

INTRODUCTION: The surgerys of the endolymphatic shunt are employed in the treatment of the vertigo of Meniere disease disabling, remains a controversial topic. Portmann in 1926, was the first to perform the surgery, incising the endolymphatic sac aimming the decrease of the endolymphatic pressure of the inner ear. Planned to create a fistula that connects the endo and perilymphatic space, the sacculotomy were described by Fick in 1964, by Cody in 1969 e by Schuknecht (cochleosacculotomy) in 1982, however they were gradually abandoned because of the high incidence of hearing loss. A new and promising surgery option of shunt, still experimental is utriculostomy, performed by Lavinsky in 1999. OBJECTIVE: Make a review of literature about the main surgical techniques of endolymphatic shunt, used in the treatment of Meniere disease, its results and the advance in the understanding of these procedures. METHODS: Based on the literature data, the main surgical techniques of endolymphatic shunt are discussed and its rationality in the treatment of Meniere's disabling disease. CONCLUSION: There are a lot of controversy over the effectiveness of surgical procedures of endolymphatic shunt for the treatment of Meniere's disabling disease, and a lot of them damage the inner ear. The experimental surgery of utriculostomy, so it seems, a promising option. Future research can give an answer to this matter.

Meniere disease; vertigo; endolymphatic sac


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