History of the Endolymphatic Sac: From Anatomy to Surgery

Objectives: To evaluate the historical descriptive origins of the anatomy of endolymphatic sac (ELS), its initial dilation description, its association with tumors, and lastly its surgical implication. Methods: A collection of historical and contemporary references, and selected textbooks were compiled spanning the 18th century to present day with specific focus on the description of the ELS, ELS dilation, and ELS tumors (ELSTs). Results: Domenico Cotugno describes the ELS in 1760. Carl Hasse introduces the term endolymphatic sac (saccus endolymphaticus) in 1873, which has remained in use till today. Carlo Mondini, in 1791, describes ELS dilation. Georges Portmann proposes opening the ELS for the treatment of Ménière's disease (MD) in 1926. In 1984, the first reported case of an ELST is described with pathology consisting of an adenoma. Four years later, in 1988, the first report is published suggesting ELSTs in direct association to von Hippel-Lindau disease. Conclusion: Domenico Cotugno is precise in describing the ELS in 1760. A timeline of important events relating to the ELS is presented. These include ELS dilation, surgical opening of the ELS for Meniere's, and ELSTs relating to von Hippel-Lindau disease.

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