Cochlear implantation in Meniere's disease

Meniere's disease (MD) is characterized by fluctuating hearing loss, episodic vertigo, tinnitus, and aural fullness. Whether secondary to intervention or to natural disease progression, a considerable subset of patients with MD has nonserviceable hearing in at least one ear. As such, cochlear implantation counseling and decision-making in the setting of MD must take into account the patient׳s surgical history. In patients who have undergone prior surgical labyrinthectomy, particular care must be taken in identifying the incus and facial nerve as the lateral semicircular canal has been removed. Labyrinthectomy and cochlear implantation can also be performed simultaneously, with most authors identifying and exposing the round window through a posterior tympanotomy before undertaking the labyrinthectomy. Although there were initial concerns regarding audiometric outcomes due to neural damage or ossification following implantation after a prior labyrinthectomy, studies have shown that the audiologic benefits are similar to the general postlingually deafened adult population.