Sac surgery on the only or better hearing ear.

In a neuro-otological practice, many patients are seen with bilateral Meniere's disease. Some of these poor prognostic cases start in childhood or adolescence. Of all the conservative operations, endolymphatic sac surgery alone should be considered for the only or better hearing ear. The risk of surgical anacusis is less than 2 per cent, a risk outweighed by the significant short and long term benefit for these difficult patients. Including patients who undergo revision surgery, control of vertigo is very acceptable, and hearing gain, especially in only hearing ears, is often essential for rehabilitation. The best results probably are obtained when surgery is performed early in the course of the disease.