Surgical Treatments
The Spinal Shunt:
It is believed that Meniere's disease is caused by an excess of balance fluid in the middle ear. If the fluid level can't be controlled by a low salt diet, a doctor might provide you with the spinal shunt option which has been available for many years. Essentially the spinal shunt is an elaborate and delicate surgery that places an overflow valve in your middle ear. When the level of balance fluid in your middle ear becomes too high, the excess flows through a tiny surgically added pipe to your spinal column where it drains into the existing spinal fluid. I don't have statistics available, but apparently this treatments has only a moderate success rate. The surgery is successful, it just doesn't make the balance disorder any better. Although apparently, this surgery has provided relief for some people. I believe that this surgery requires opening of the skull which makes it an extremely serious operation, probably requiring a day in intensive care and a few days in the hospital after the surgery.
Transtympanic Gentamicin Injection - TTG & Vestibular Nerve Section :
Both of these techniques are very similar in terms of their objective, which is to prevent nerve impulses from you vestibular organ from getting to your brain.
In the Transtympanic Gentamicin Injection procedure (which is done in the doctors office), the defective vestibular organ is injected with Gentamicin (a powerful antibiotic) through the ear drum. The Gentamicin destroys the tiny hair like fibers that transmit balance information to the brain. This techniques causes days (or even weeks) of profound dizziness, but eventually the body compensates by relying on the other vestibular organ. Vestibular therapy may be required to help the patient's other vestibular organ adjust more quickly. This procedure may need to be done several times to kill all the tiny hairs. In 80 to 85% of the cases, dizziness is eventually eliminated. Unfortunately there is a 20% change of total hearing loss in the injected ear, each time the procedure is done.
Disconnecting the vestibular organ from the brain (Vestibular Nerve Section) is a surgical procedure in which the vestibular nerve that transmits signals from the vestibular organ to the brain is cut where it connects to the brainstem. This techniques causes days (or even weeks) of profound dizziness, but eventually the body compensates by relying on the other vestibular organ. Vestibular therapy may be required to help the patient's other vestibular organ adjust more quickly. Apparently this procedure "cures" 95% of the people who have it done. This is a serious operation where the skull needs to be opened so a day in intensive care and a few days in the hospital after the surgery are required. Risks for this procedure include possible hearing loss and brainstem injury, which can't be a good thing.
There is another major problem with these two procedures that I thought of, that wasn't originally mentioned by my doctor. What caused the balance problem is my right ear is unknown. In addition what causes Meniere's Disease is also (pretty much) unknown. If I had any of these procedures done, what would happen to me if I had a problem with the vestibular organ in my other ear? The answer was that it was possible that I would have no balance at all and be left permanently "floating". For me, the thought of being a "floating", half deaf man convinced me that surgery was not an option.
