Endolymphatic sac revision for recurrent intractable Meniere's disease.

Meniere's disease can be observed uniquely in revisions of the conservative surgical procedure for endolymphatic sac enhancement, which preserves the labyrinth, unlike destructive procedures. Genetic anatomic abnormalities in patients lead to malabsorption of endolymph and symptoms of Meniere's that are reversed by endolymphatic sac enhancement, but disabling symptoms eventually may recur in a few cases and require revisional surgery. We observe developing pathophysiologic conditions intraoperatively and have modified our techniques to accommodate the redeveloped pathogenesis we observe and avoid complications found with earlier techniques. This conservative treatment allows patients (many of whom may develop bilateral Meniere's) to retain capacity to accept cochlear implants should they become advisable later.