ENT 2026

Ménière’s disease (MD) is a chronic inner ear disorder characterised by disabling spontaneous episodes of vertigo, fluctuating sensorineural hearing loss and tinnitus for which the symptom burden can be high. The aetiology is unclear but it is generally attributed to increases in endolymph volumes (endolymphatic hydrops). Various lifestyle and medical therapies are tried but if these fail, surgical treatments can be considered, Endolymphatic sac decompression (ESD) is recognised as a surgical option in patients where hearing preservation is important, however, provision of this procedure in the United Kingdom has become critically limited with few surgeons still performing it and many senior practitioners approaching retirement, We present a single-surgeon series of 42 cases undergoing ESD for confirmed MD over a 15-year period, across St Mary’s Hospital, Isle of Wight and Queen Alexandra Hospital, Portsmouth (26 female, 15 male; age range 32–84 years), Symptom control was achieved in 87% of patients. Two patients experienced recurrence, one of which had recurrence twice. One required grommet insertion due to negative pressure and the other required revision surgery, These outcomes are consistent with review of the international literature reporting significant vertigo reduction and hearing preservation following ESD. This low-risk surgical option compares favourably with labyrinthectomy, which carries a substantially higher risk of hearing loss, Endolymphatic sac decompression remains an effective non-destructive, hearing-sparing option for medically refractory incapacitating MD yet shrinking surgeon numbers and minimal trainee exposure risks the loss of this surgical option from UK practice. Preserving surgical training pathways is essential to safeguard patient access to this treatment.

Dr Ciara Lynch studied Medicine (MBBS) and Biomedical Science (BSc Hons) at St George's, University of London. She is currently a Foundation Year 2 doctor at St Mary's Hospital, Isle of Wight, with a keen interest in ENT. She is working under Mr Sreeshyla Basavaraj, ENT Consultant at St Mary's Hospital and Queen Alexandra Hospital, and presents this case series as part of their departmental work.