Labyrinthine cryosurgery for Meniere's disease--present status.

When surgery is required to control attacks of vertigo caused by Meniere's disease, total labyrinthectomy performed by the transcanal or transmastoid approach is the procedure of choice when the disease is unilateral and has permanently damaged hearing to the point that only a distorted remnant remains and amplification would not be effective. For patients with bilateral Meniere's disease or unilateral cases with sufficient hearing to warrant its preservation, a surgical procedure is required that eliminates the vertigo and either improves or at least does not adversely affect the hearing. Labyrinthine cryosurgery has been used clinically since 1965 in an attempt to achieve this goal. The results of 225 procedures followed for 1 year or longer indicated that vertigo is controlled in 73% but not in the remaining 27%. Hearing seemed unaffected by cryosurgery. If hearing fluctuated prior to surgery, it generally continued to fluctuate afterward. Improved or decreased hearing could therefore not be interpreted as a direct result of surgery but rather as a continuation of the fluctuation in hearing that commonly occurs in this disorder.