Neuro-ophthalmology and neuro-otologySurgical treatment of Ménière's diseaseVan de Heyning, Paul H; Wuyts, Floris; Boudewyns, AnAuthor Information University Department of Otorhinolaryngology Head and Neck Surgery, Antwerp University Hospital, Antwerp, Belgium Correspondence to P.H. Van de Heyning, University Department of Otorhinolaryngology Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Wilrijkstr 10, 2650 Antwerp, Belgium E-mail: [email protected] Current Opinion in Neurology: February 2005 - Volume 18 - Issue 1 - p 23-28 Buy Abstract Purpose of review This review comprises new insights from and discusses the impact of recent medical publications on the surgical treatment of Ménière's disease. Recent findings Refining surgical indications through recognition of clinical conditions with similar symptoms and through a more precise estimation of the degree of disability will improve the process of decision making for surgery. Further high-level evidence-based medical data supporting the effectiveness of intratympanic gentamycin has become available. Physiopathological progress, based on animal experiments, towards surgically applied intracochlear drug delivery is addressed. Summary Studies using level 1 or 2 evidence-based medicine must be conducted to enable better decision making, such as in the application of intratympanic gentamycin or micropressure Meniett therapy at an earlier stage of Ménière's disease. If the results of such studies are conclusive for surgery, this will lead to a shorter duration of discomfort for patients before being offered the possibility of surgery. Abbreviations AAO-HNS: American Academy of Otolaryngology and Head and Neck Surgery; ELH: endolymphatic hydrops; ITG: intratympanic gentamycin; NVC: neurovascular conflict; QOL: quality of life; SNHL: sensorineural hearing loss. © 2005 Lippincott Williams & Wilkins, Inc.