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ENT · Meniere's disease: intractable vertigo
Sample itemA patient with Meniere's disease has disabling vertigo and a non-serviceable (dead) hearing in the affected ear despite medical therapy. Which procedure is the most suitable?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
A. Labyrinthectomy
Where hearing is already poor, a destructive procedure such as labyrinthectomy or chemical ablation with gentamicin effectively controls vertigo. Sac decompression preserves hearing and is chosen when hearing is serviceable.
Option by option
A. Labyrinthectomy (correct)
Correct. Labyrinthectomy is suitable when hearing is already lost.
B. Cochlear implantation
A cochlear implant treats hearing loss, not vertigo.
C. Endolymphatic sac decompression
Sac decompression is chosen to preserve useful hearing.
D. Insertion of grommet
Grommets do not treat vertigo.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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