BACKGROUND: Ménière’s disease is an inner ear disorder causing recurrent vertigo, hearing loss, and tinnitus. Diagnosis is based on the variability of the symptoms over time and absence of radiological abnormalities. Medical therapy is effective only in a small percentage of patients. Surgical strategies remain controversial. In this article, we revisit a surgical technique neglected over the years: endolymphatic sac surgery. METHODS: Fifty-four patients affected by Ménière’s disease underwent endolymphatic duct and sac decompression. According to the American Academy of Otolaryngology–Head and Neck Surgery criteria, vertigo control was evaluated with follow-up at 6 months, 1 year, and 2 years from the intervention. Hearing results were evaluated before the surgery and at 2 years of follow-up using the pure tone average. The results were compared with similar techniques of endolymphatic sac surgery described in the literature. RESULTS: According to the American Academy of Otolaryngology–Head and Neck Surgery criteria classification, 2 years after surgery, 87% patients achieved complete control of vertigo (class A). The hearing remained stable in 93.5% of patients. The results appear compatible with other publications data regarding endolymphatic sac surgeries. CONCLUSION: The duct and endolymphatic sac decompression allows the control of vertigo and preserves hearing from the pathological effects of Ménière’s disease. The revised technique allows the functional restoration of endolymphatic homeostasis. Cite this article as: Salvinelli F, Bonifacio F, Bigliardo C, et al. Endolymphatic duct and sac decompression: A new life for an old technique. J Int Adv Otol. 2023;19(6):511-516.
Background: Odontogenic sinusitis (ODS) is a condition needing a multidisciplinary approach to be suc-cessfully treated. Effective communication between the involved health providers reduces chances of errors and treatment failure. Purpose: This study proposes a new classification of ODS facilitating the communica-tion of pivotal information. Study design, setting, sample: In this observational study the authors considered 124 consecutive patients with ODS treated in the Campus Bio-Medico of Rome Foundation Hospital. Predic-tor/exposure/independent variable: The main elements influencing the treatment of this condition resulted as: Timing, Etiology, Presence of foreign Body, maxillary Obstruction of the ostiomeatal complex, and pres-ence of oroantral Fistula (OAF); these elements were organized in the acronym TEBOF. Main outcome varia-bles: Each patient received a TEBOF classification. The “T” was categorized in “Tc” for patients diagnosed with chronic sinusitis, “Ta” for of acute sinusitis, and “T0” for patients with maxillary sinus foreign body without sinusitis. The “E” was differenciated in “Ec” when the condition was a side effect of a primary dental pathology, “Eb” when the initial cause was not a dental implat, and “Ea” for when the initial cause was having a dental implat placed. “B" was reported as “B1” when there was a maxillary sinus foreign body and “B0” when there was not. “O” was reported as “O1” when the ostiomeatal complex resulted closed and “O0” when it was clear. “F” was used as “F1” when there was a communication, and “F0” when there was not. Covariates: A preliminary assessment considering the change in the classification in the groups of patients that underwent different therapeutic approaches. Analyses This classification provides a concise and easy-to-understand combination facilitating communication between the various healthcare providers who are essential for the appropriate treatment of this condition. Results: TEBOF classification provides similar data of other analogues, but signals clearly pivotal clinical elements. Conclusions and Relevance: In the au-thors opinion this classification provides a more rapid, complete and clear way to transfer information be-tween health professional. This classification could contribute insight useful to decide the type and the timing of the therapeutic approaches.