A new approach to surgery for Menière's disease: talking about surgery.

Many patients experience a remission of their Menière's disease between the time that surgery is agreed and their admission to hospital for the procedure. In a series of 23 consecutive patients where surgery appeared to be indicated for control of the vertigo of Menière's disease, 12 settled within 6-8 weeks of agreeing that something would be done, and thereby avoided any surgical procedure. It is suggested that these patients may have been experiencing the same effect as provided by the conservative surgical procedures. In the absence of any clear evidence for a specific surgical effect from any conservative operation for Menière's disease, the authors put forward the suggestion that abandoning all the conservative procedures in favour of the protocol of planned surgery should be considered; wait for 2 months and, if the incapacitating episodic dizziness continues, one should proceed to a differenting procedure.