Decompression and Drainage of the Endolymphatic Sac

This is a brief statement of the principles underlying the concept of opening the endolymphatic sac, which is presented from the standpoints of technique, pathogenesis, and selection for surgery according to the type of vertigo. Opening the endolymphatic sac is only indicated when the diagnosis of typical Meniere's disease is certain, ie, when attacks of labyrinthine hydrops occur. As this operation does not have as good a result in the long run as destruction of the posterior part of the labyrinth, it is logical to prefer the latter in cases where the patient is already almost completely deaf but a patient with vertigo of peripheral origin that cannot definitely be labeled as Meniere's disease should have a neurectomy (scarpectomy) of the eighth cranial nerve.