Round window ultrasonic irradiation: conservative surgery for Meniere's disease.

Ultrasonic irradiation of the labyrinth through the round window approach is a minimally destructive method of surgical management for Meniere's disease. Results of 48 procedures, followed from six months to eight years, are reported. Relief from vertiginous symptoms was obtained in 70 percent of the patients. Hearing was improved in 14 percent; hearing was also significantly worse in 14 percent. These findings resulted in an overall 56 percent of the patients falling into American Academy of Otolaryngology control classes A or B. No significant postoperative complications were observed. Results are difficult to classify on a cause-and-effect basis due to the remissions and exacerbations characteristic of Meniere's disease. Ultrasonic irradiation using the round window approach does not involve the potential risks of such surgical procedures as labyrinthectomy, vestibular neurectomy, and endolymphatic sac procedures. The primary disadvantage of this procedure is securing and servicing the instrumentation. Due to its conservative nature, ultrasonic irradiation through the round window is an attractive surgical consideration until such time when the pathologic processes in Meniere's disease are better understood.