Surgical therapy in Menière’s disease

Abstract

After P. Meniere's first description of the typical symptoms in 1861 it took more than 40 years before the first otosurgical procedures were performed to cure Meniere's disease. Various surgical methods were established during the twentieth century, which still are employed in the treatment of intractable Meniere's disease, especially saccotomy and vestibular neurectomy but also intoxication of the labyrinth by intratympanic application of gentamicin. Despite the good results of such therapeutic regimens the basic pathological mechanism is still not fully understood. Since the description of an endolymphatic hydrops by Hallpike und Cairns in 1938 as a typical feature, there have been some observations of a possible infectious, allergic and autoimmunological (co)pathogenesis without enough proof to explain the disease in every case. This article aims to present the current scientific data, diagnostics and therapy of Meniere's disease with special emphasis on surgical treatment options.