Cochleosacculotomy revisited. Long-term results poorer than expected.

Cochleosacculotomy has been described as a simple, efficacious treatment for relief of vertigo in patients with Meniere's disease in whom medical therapy has failed. We reviewed records of 11 elderly patients with good vestibular function who were thought to be ideal candidates for this procedure. Average follow-up was 17 months. Contrary to previous reports, long-term control of vertigo was poor, and more than 80% of the patients suffered a significant hearing loss from this procedure. Four of 11 patients required a second surgical procedure to control their vertigo. Audiometric measures revealed statistically significant postoperative increases in puretone thresholds at all frequencies and speech reception threshold, and a decrease in discrimination scores. Based on the results of this study, we no longer plan to use cochleosacculotomy for the treatment of elderly patients with Meniere's disease.