An update on the surgical treatment of Ménière's diseases.

Various surgical procedures have evolved for the treatment of Ménière's disease patients who are refractory to medical therapy. These can be in the form of conservative surgeries as in endolymphatic sac surgery or in the form of destructive procedures. The latter include labyrinthectomy and vestibular nerve section, which result in deafferentation of the vestibular end organ. In the past decade, intratympanic therapy with gentamycin and steroids has evolved as new methods for the treatment of Ménière's disease. The literature witnesses controversies in the effectiveness of endolymphatic sac surgery in the treatment of Ménière's disease. The choice of the surgical procedure depends on the degree of serviceable hearing, the severity of the spells, and the condition of the contralateral ear. The most commonly used procedures in the treatment of Ménière's disease and their indications are reviewed.