Surgical management of vestibular Meniere's disease with endolymphatic mastoid shunt.

The early stages of Meniere's disease may consist only of vestibular symptoms. These patients with vertigo alone may be incapacitated by this condition. A great many of these patients are unresponsive to medical therapy and tend to progress to cochleovestibular disease. Early surgery on such individuals may decrease vertigo and give the added benefit of preserving hearing. This paper reports the results of endolymphatic mastoid shunts performed on 24 patients with normal hearing who had medically uncontrolled vestibular Meniere's disease. The patients underwent surgery between 1978 and 1981, and each has been followed for at least 1 year. Vertigo was decreased or abolished in 21 of 24 patients (87%). Hearing remained unchanged in 19 of the 24 patients (79%) and was mildly impaired postoperatively in 4(16.7%). Only 1 patient had moderate postoperative hearing loss. Of the 5 patients with reduced hearing, 4 had improvement of vertigo. There were no cases of surgically-induced deafness.