Endolymphatic sac decompression has probably polarized the otolaryngology community more so than any other aspect of MD treatment. Following the publication of the Danish Sham study, 18 the procedure was largely abandoned in Europe. However, the study had methodological flaws leading many to question the validity of the results. The procedure remains popular in the United States at the present time. To do justice to this particular argument is well beyond the scope of this article. However, being Irish, I shall invoke an anecdote on the subject involving the consumption of alcohol. After a night with this author and another otolaryngologist of Polish extraction, one of the authors of the Danish Sham study conceded that the procedure might actually be effective in controlling vertigo symptoms. However, he felt that the improvement, rather than being mediated via decompression of the endolymphatic sac, was due to the surgery inflicting a degree of insult to the vestibular system, similar to the effect of low-dose gentamicin. I suspect that heated discussion on the subject of sac decompression will continue for some years to come.
Depending on timing, intra-tympanic steroid injection is also offered (dexamethasone 10-24mg/cc). Intra-typmpanic steroid injection is performed by inserting a needle through the eardrum and injecting about of highly concentrated steroids directly into the middle ear space. The patient is than instructed to keep the affected ear up for 30 minutes without swallowing, yawning, or popping the ear. After injection, the patient is allowed to immediately resume normal activities. This steroid injection has also been used to treat Meniere's Disease flare-ups.
As of July 2012, a visit to the National Library of Medicine’s search engine, PubMed, revealed 497 research articles concerning AIED disease published since 1964 with eleven of these published in the last year. In spite of this moderate effort by the medical research community, AIED disease remains a chronic, incurable disorder that causes progressive disability to both hearing and balance. At the American Hearing Research Foundation (AHRF) , we have funded basic research on similar disorders in the past , and are interested in funding research on AIED in the future. We are particularly interested in projects that might lead to methods of stopping progression of hearing loss and the disabling attacks of dizziness. Get more information about contributing to the AHRF’s efforts to detect and treat acoustic neuroma.