Current Status of Surgery for Meniere's Disease

Abstract

Surgical intervention is indicated in Meniere's disease when symptoms persist in spite of an adequate trial of medical therapy. At The Otology Group, three surgical procedures are employed for the individual not responding to medical management. These are (1) the endolymphatic mastoid shunt, (2) the middle fossa vestibular nerve section, and (3) the translabyrinthine labyrinthectomy. The selection of the surgical procedures depends on a number of factors, including age, severity of symptoms, status of the contralateral ear, and hearing in the affected ear. As a general rule, if the patient has serviceable hearing, the first operation suggested is the endolymphatic shunt because of its low morbidity. Should this procedure fail, the middle fossa approach is recommended if the patient is not over 60 years of age. Translabyrinthine labyrinthectomy is recommended for those patients over 60 years of age as well as for younger patients with unilateral profound hearing loss.