Introduction
Meniere patients are a heterogenous group of patients regarding degree and duration of the various symptoms, and the disease are probably caused and influenced by many factors. In the worst affected cases surgery has been suggested to cause good result whereas others have claimed that a more conservative or less invasive therapy should be preferred.
In this peculiar paper, Jens Thomsen and collaborators, perform a prospective, randomized study comparing the effect of two surgical procedures in the treatment of patients with Meniere's disease. Fifteen patients had an endolymphatic shunt inserted and 14 patients just a ventilation tube inserted in their tympanic membranes. The treatment effect was striking in both groups with no difference between the groups. When asked about their subjective impression of the effect of the treatment, the ventilation tube group was more favourable compared with the saccus group, though not statistically different. The authors suggest that patients with Meniere's disease, who have vertiginous symptoms refractory to medical treatment should be offered insertion of a ventilation tube in the tympanic membrane as the first choice of treatment, an advice which many ENT doctors have adopted.
