Assessement of surgical procedures for Ménière's disease

There are numerous surgical procedures for the treatment of Meniere's disease, and the current status of their efficacy is controversial. A review of the literature is presented as a basis for the evaluation of the relative merit of these procedures. Emphasis is placed on endolymphatic sac procedures, sacculotomy, vestibular neurectomy and labyrinthectomy. Vestibular neurectomy and surgical labyrinthectomy provide high rates of improvement in vertigo. The hearing is frequently made worse by vestibular neurectomy. Endolymphatic sac procedures result in improvement in vertigo less frequently. They are most likely to improve hearing. Although sacculotomies are associated with improvement in vertigo in approximately 80% of patients, they are associated with high rates of hearing loss.