Controversy in menière's disease: results of microvascular decompression of the eighth nerve.

We have identified a group of patients with classic symptoms of Meniere's disease, all of whom had abnormalities of brain stem auditory evoked potentials and middle ear acoustic reflex response that strongly indicated auditory nerve and brain stem involvement. Ten patients with disabling symptoms and retrocochlear audiologic signs were selected to undergo microvascular decompression of the eighth nerve at its exit from the brain stem (root exit zone [REZ]). In all 10 patients, the eighth nerve was found to be significantly compressed by one or several vessels near its REZ. One patient died 4 months after the operation from an unrelated cause but had been free of symptoms of Meniere's disease until her death; the remaining nine patients have all been free from vertigo for 8 to 48 months after the operation. None of the patients suffered any complications as a result of the surgical procedure.