Clinical experience with a surgical approach to hydrops.

This work was based upon the need to look at the role of surgical intervention in cases of presumed hydrops encountered in usual medical practice. A retrospective cohort study of 292 consecutive cases diagnosed as Meniere's disease was used to identify subjects severely enough affected to elect surgical relief. Two nested case-control design studies were subsequently conducted: one to compare surgical failures (4 cases) with successes (15 controls); and the other to compare the surgical group (19 cases) with a uniform random sample of all presenting Meniere's disease cases (10 controls). These data suggest the following testable hypotheses: (1) the younger the age of onset, the higher the probability that surgical intervention will be required to control episodic vertigo; (2) the younger the age of onset, the higher the probability of the failure of nondestructive surgery; and (3) patients destined for surgical intervention are likely to require at least twice as much office-based medical care as the general group of presenting Meniere's patients. A biological question arising from these data is, Does age influence the putative homeostatic pathophysiology implicated in hydrops?