If Meniere’s disease cannot be controlled by conservative therapy, the following ENT surgical procedures are used:
1st order
- Insertion of a tympanostomy tube – led to improvement in more than two-thirds of patients.
- Saccotomy (endolymphatic shunt surgery: opening of the saccus endolymphaticus) – a meta-analysis showed that these procedures also controlled vertigo attacks in the long term in about three-quarters of patients
- Elimination of the vestibular organ (organ of balance) by ototoxic drugs (substances that have a destructive effect on the inner ear, especially the sensory cells of the hearing and balance organ, or the associated cranial nerve); neurectomy of the vestibulocochlear nerve/hearing balance nerve) [ultima ratio therapy].
- Elimination of the vestibular ganglion.
- Labyrinth destruction: destruction of the labyrinth in extinguished hearing with simultaneous cochlear implantation* → arrest of attack vertigo and hearing improvement.
* Cochlear implantation (cochlear implant) – hearing prosthesis for people with severe to profound hearing loss (complete deafness) or even when inner ear function is no longer adequate; electronic medical device that takes over the function of the damaged parts of the inner ear to transmit audio signals to the brain (therapy of choice for unilateral or bilateral deafness).
