Therapeutic options in Meniere's disease.

Emphasis on treatment in Meniere's disease has recently shifted from a concentration on the vertiginous component alone to include conservation or improvement of hearing as well. This presentation tabulates the current otological literature's reports of both the medical and surgical options available in the treatment of Meniere's disease. The authors conclude that these more recent reports deemphasize the importance of the vertiginous component, while emphasizing the importance of the hearing component in evaluation of the efficacy of any therapeutic modality. Furthermore, these reports indicate that endolymphatic sac decompression and drainage surgery alone offers a considerable chance for conservation or improvement in hearing, as well as relief of vertigo in early cases of reversible, fluctuating hearing deficits. In nonreversible or nonfluctuating hearing deficits with hearing worth conserving, vestibular neurectomy with excision of Scarpa's ganglion yields the best results.