This is a nice summary of the evidence available for the surgical treatments for intractable Meniere’s disease. To summarise, in five-10 years, over 90% of vestibular neurectomy cases, more than 80% of intratympanic gentamycin treatment, and 70-80% of endolymphatic sac surgery achieved complete control of vertigo in comparison with 25-70% of non-operative cases. Hearing was preserved in 60-80% patients who underwent endolymphatic sac surgery, 50-60% patients who underwent neurectomy or gentamycin in comparison with 25-50% on non-operative cases. The author acknowledges that gentamycin is popular due to its convenience and suggests that sac surgery may deserve more consideration having lost credibility from the Danish Sham study.

Evidence of surgical treatments for intractable Meniere’s disease.
Kitahara T.
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Ravi Thevasagayam

Clinical Lead, Department of ENT, Sheffield Children’s Hospital, Sheffield, S10 2TH, UK.

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