This paper analyzes 50 consecutively performed endolymphatic mastoid sac shunts. Regardless of method used, vertigo was controlled in approximately 52% of the cases.It is suggested here that, regardless of the method employed, there remains a high likelihood that the symptoms will recur, and the question is raised as to whether sac surgery may merely induce a temporary remission of the disease process. Consequently, it is hereby proposed that there is a need to devise a method to permanently drain the endolymph in order to more effectively control the disease on a permanent basis.