Natural course of Menière's disease in surgically-selected patients.

Menière's disease (MD) is considered a complex otologic disorder characterized by exacerbation and remission periods which often make its natural course unpredictable. Several studies in the past have analyzed the evolutionary course of MD through comparison between patients under medical treatment and those surgically treated. The present paper aimed to study the evolution of MD in a group of patients who were selected for endolymphatic sac surgery on the basis of a fluctuating stage and uncontrollable recurrent vertigo; some of them, however, did not undergo surgery for different reasons and were used as control for MD at a homogenous stage. Vertigo and tinnitus were improved by surgery in a significant number of patients in comparison with the non-surgical group. Hearing function, which improved few months after surgery in some patients, was found to deteriorate in the long run, in surgical and non-surgical groups. Sac surgery yielded significantly better results for two out of three Meniere's symptoms, i.e. vertigo and tinnitus, and can be considered to play a significant role in the therapy of MD at the fluctuating stage.