Note: Be careful with spelling and accentuation of the search words.
Endolymphatic Sac Decompression
Meniere’s syndrome
 |
 |
| 1. Planning of the incision. | 2. Elevation of the skin flap anteriorly. |
 |
 |
| 3. Elevation of the periosteal flap posteriorly. | 4. Starting mastoidectomy. |
 |
 |
| 5. Antrotomy. The short process of the incus and the lateral semicircular canal are seen. | 6. Drilling in the region of the mastoid tip searching for the digastric ridge. |
 |
 |
| 7. Digastric ridge. The change in the colour of the muscle is seen. Medially, the area of the sigmoid sinus. | 8. Drilling for the skeletonization of the sigmoid sinus. |
 |
 |
| 9. The sigmoid sinus is seen. | 10. Drilling anteriorly the sigmoid to uncover the dura of the posterior cranial fossa and the endolymphatic sac. |
 |
 |
| 11. Removing the mastoid air cells behind the facial nerve and below the labyrinth. | 12. A rough image of the lower limit of the posterior semicircular canal. |
 |
 |
| 13. Drilling to uncover the dura of the posterior cranial fossa and the endolymphatic sac. | 14. Removing the bone above the jugular bulb and medially to the facial nerve. |
 |
 |
| 15. Detachment of the dura from the medial surface of the temporal bone. The formation of the Bill’s island on the sigmoid is seen. | 16. The endolymphatic sac is seen almost fully uncovered (beneath the round knife). |
 |
 |
| 17. Trying to remove the bone medially the sac. We do not recommend opening the sac. | 18. Completion of the operation, suturing the wound, and insertion of a ventilation tube. |
