# Endolymphatic sac surgery: past and present controversies

## TL;DR

This paper reviews the history and evolving understanding of endolymphatic sac surgery and its role in treating vertigo.

## Contribution

The paper challenges the original concept of passive drainage and proposes a new hypothesis for vertigo attacks.

## Key findings

- The original passive drainage concept is challenged as more is learned about the endolymphatic sac's physiology.
- Surgery can damage delicate cells, and techniques like excision and duct clipping are discussed.
- A new hypothesis is proposed to explain how vertigo attacks occur.

## Abstract

The history of endolymphatic sac surgery is presented. The original concept of passive drainage is challenged as the physiology of the endolymphatic sac is gradually elucidated. Surgery causes damage to the delicate cells with the concept of endolymphatic sac excision and endolymphatic duct clipping discussed. The author presents a hypothesis of how vertigo attacks occur.