Cervical Sympathectomy in Meniere's Disease

A recurring labyrinthine microcirculatory fault is held to be the basic fault in Meniere's disease. Characteristic hydrops is, thus, osmotically induced but, once established, may exert secondary effects. Only a few patients require surgery. Widely different methods often attain success, but no particular technique is applicable in all cases. Patients requiring surgery are grouped into four categories. Where both or the only useful ear is involved, bilateral cervicothoracic sympathectomy (C8-T3) offers the best chance of success with minimal risk. Reasons dictating this type of sympathetic resection are stated with longterm results in 247 patients. Some degree of renewed sympathetic activity inevitably occurs after two years and correlates well with the partial relapse of vertigo in 12% at this period. These results are shown graphically. Fifty percent maintain complete long-term relief of vertigo. Hearing and tinnitus improve in lesser proportions.