Endolymphatic Sac Decompression Surgery for Refractory Menieres Disease

PROGRAM DESCRIPTION: This case demonstrates an endolymphatic sac decompression performed on a 65 year old female presenting with left side Meniere’s Disease refractory to sodium restriction and medical management. The high definition surgical video provides an excellent overview of surgically relevant anatomy outlined in a logical and stepwise progression. The goal of the presentation is to assist the general otolaryngologist and/or otologist in the consistent and safe performance of this technique. Utilizing video-augmentation overlay editing, the video provides the audience with incorporated structure captions, anatomical highlights, and instructional diagrams to maximize understanding and operative progression through this oftentimes challenging anatomy. Key considerations include: pearls for success early in the approach, a visual walkthrough of critical anatomical waypoints, and a multi-faceted presentation of Donaldson’s line and its utility for identifying the endolymphatic sac. This patient’s 12 month post-operative outcomes are reviewed.
Outcomes

Objectives:
1. Recognize the facial nerve and posterior semi-circular canal as key landmarks for identification of the endolymphatic sac.
2. Understand the orientation of Donaldson's line and it implications for locating the endolymphatic sac.
3. Demonstrate variability in the location and orientation of the endolymphatic sac to the posterior fossa dura.