Surgical Management of Menière's Disease: Our Experience
30 September 2019 (online)
Introduction Menière's disease, even though is a distressing condition, responds well to medical management. In patients with Menière's disease, refractory to intratympanic gentamicin and management with surgical options need to be assessed. Here, we are sharing our experience of surgical management of Menière's disease.
Case Presentation Patients, with Menière's disease, who are refractory to intratympanic gentamicin therapy were subjected to either endolymphatic sac decompression or vestibular neurectomy. During the past 10 years, we had around four to five patients per month with Menière's disease. All were managed conservatively. Out of these, six patients were refractory to intratympanic gentamicin therapy. Among them, four patients underwent endolymphatic sac decompression. Complications encountered in one patient were hearing loss and CSF leak. Another patient developed vertigo after 7 years, who was conservatively managed. Two patients underwent vestibular neurectomy, of which one patient had wound infection and meningitis which was managed medically. All patients are on regular follow-up.
Discussion Surgical modalities like endolymphatic sac decompression, vestibular neurectomy and labyrinthectomy, definitely have a key role in management of refractory cases of Menière's disease.
Conclusion Although intratympanic gentamicin has revolutionized the treatment of Menière's disease, there are still refractory cases which can be managed with surgery efficiently.