Ménière's Disease: Surgeries

Surgery for Ménière's disease can cause permanent damage to your hearing. Talk with your doctor about surgical options if repeated attempts at less invasive treatment methods have failed to relieve your symptoms.

Endolymphatic surgeries

The cause of Ménière's disease is unknown, but it may be related to a fluid imbalance in the inner ear. This fluid (endolymph) is contained in a part of the inner ear called the endolymphatic sac. Two surgeries may be done:

• An endolymphatic shunt is a small tube inserted in the endolymphatic sac to allow excess fluid (endolymph) to drain. When the excess fluid can drain, pressure does not build up and vertigo does not occur.
  • The effectiveness of this procedure has become controversial, so it is rarely done. This surgery may cause hearing loss.
• In endolymphatic sac decompression, a small amount of bone is removed from inside the ear. This provides more room for the endolymphatic sac when it swells with too much fluid. When there is more room for the sac to swell, pressure inside the inner ear is avoided and vertigo does not develop.

Vestibular nerve section

In vestibular nerve section, the nerve that controls hearing and balance on the affected side is identified. Then the balance portion of that nerve is cut, leaving the part of the nerve that controls hearing intact. The part of the nerve that controls hearing is close to the part that controls balance, so there is a risk of hearing loss in the affected ear.

During the recovery period, the brain adapts to the lack of input from the ear that was operated on, and normal balance sense usually returns. Other symptoms of Ménière's disease, such as tinnitus, hearing loss, and fullness in the ear, aren't helped by this surgery. You may need to stay on a low-sodium diet and take diuretics.

This procedure requires general anesthesia and a hospital stay.

Labyrinthectomy

Labyrinthectomy removes the balance center of the inner ear (labyrinth). This nearly always stops vertigo but also results in total hearing loss in that ear. It is only used for people who have already lost most of their hearing.