Ménière's disease tends to be self-limiting and the great majority of patients are best managed conservatively. A small minority continue to suffer so severely that life is a misery, and for these surgical treatment is worth considering. The operations are sympathectomy, destructive procedures such as labyrinthectomy, alcohol injection and 8th nerve section, and endolymphatic decompression. Sympathectomy is of doubtful value. Most destructive operations, though effective, destroy hearing, and if the condition develops in the other ear, which it may, destruction of hearing on both sides is out of the question. Endolymphatic decompression is achieved by implanting a silicon rubber tube to join the endolymphatic sac with the subarachnoid space, a difficult and relatively new operation.
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