Endolymphatic sac surgery for Menière's disease: eighteen years' experience with the Kitahara sac operation.

From 1968 to 1983, 162 cases of Meniere's disease were treated surgically with our intramastoid drainage technique. One hundred forty of these cases could be followed up for two years or more. Treatment results were calculated according to the 1972 AAOO criteria and the 1985 AAO-HNS criteria. Using our technique, definitive vertigo spells could be controlled completely in 78% of cases and substantially controlled in 94%. Hearing worsened in only 15% of all cases. Therefore, prevention of worsening of hearing, especially in bilateral cases, and control of vertigo spells in patients with frequent attacks were considered absolute indications for our technique. In this study critical observations were made based on the number of cases hitherto reported by surgeons (the average number of patients undergoing surgery in our clinic was fourteen per year). The need for careful selection of patients for surgery is emphasized.