Cochlear dialysis for Menière's disease. An update.

The early results of hyperosmolar perfusion of the scala tympani for advanced Meniere's disease were reported in 1987. Thirty patients were treated in this way between March 1981 and March 1986; follow-up is now 2 to 7 years. The rationale of cochlear dialysis is to reduce the endolymphatic hydrops of the pars inferior by filing the scala tympani with a sterile solution of mannitol in 5% dextrose that has an osmolality of 350 m.osm per liter, which compares with a scala media osmolality of circa 300 m.osm per liter. The technique is a qualitative and quantitative extension of the "salt in the round window niche" used as far back as 1972 by Arslan.