Surgical Labyrinthectomy and Cochlear Implantation in Menière's Disease.

Objective:The aim of this study was to analyze the results of labyrinthectomy and cochlear implantation (CI) on hearing, vertigo, and tinnitus and evaluate the adequacy of labyrinthectomy and CI for the treatment of end stage Meniere's Disease (MD).Study Design:Retrospective case review.Setting:Tertiary referral center.Patients:Charts of 22 patients undergoing labyrinthectomy and CI in the same ear for intractable vertigo and hearing loss with both preoperatory and postoperatory documentation available, were reviewed.Intervention(s):Therapeutic.Main Outcome Measure(s):Auditory outcomes were assessed with pure tone and speech audiometry, and compared with the preoperatory audiometric evaluation. Dizziness was graded according to the Dizziness Handicap Inventory Questionnaire (DHI). Tinnitus outcomes were assessed by the tinnitus handicap inventory (THI).Results:Post-CI pure tone average had a statistically significant improvement (p=0.035, paired t test). Speech audiometry resulted in a non-statistically significant speech discrimination score variation (p=0.056, paired t test). Postoperatory THI had a statistically significant variation (p=0.0001, paired t test). Sixty seven per cent of the patients had complete resolution of the vestibular symptoms in their operated ear, however, patients over 70 years old had significantly more failures as evinced by the postoperative DHI (p=0.0109, Fisher's exact test).Conclusions:Patients affected by end stage MD or secondary MD, with vertigo and severe hearing loss can successfully undergo labyrinthectomy and CI. Caution should be reserved in elderly patients for a risk of persistent instability. The CI confers significant benefit in hearing rehabilitation and tinnitus suppression.