Our findings indicate that the more conservative surgical procedures--endolymphatic sac surgery, cochleosacculotomy, and streptomycin perfusion--are all as effective as and less destructive than labyrinthectomy for controlling vertigo.
An initial transmastoid labyrinthectomy was performed on 56 patients, ELS surgery on six, and cochleosacculotomy on five.
A complete relief of symptoms was achieved in four of the five patients who underwent a cochleosacculotomy. The remaining patient was subsequently and successfully treated with vestibular streptomycin perfusion (see case report 3).
When 4 months of medical treatment proved to be ineffective, a cochleosacculotomy was performed on the left ear.
Cochleosacculotomy was successful in four of five patients; the one patient who failed was subsequently and successfully treated with streptomycin perfusion.
This suggests that in order to relieve symptoms in patients with ipsilateral DEH, more conservative measures such as ELS surgery, cochleosacculotomy,  and streptomycin perfusion can be chosen arbitrarily as either primary or subsequent procedures as an alternative to labyrinthectomy.
Preservation procedures include endolymphatic sac surgery and cochleosacculotomy. Ablative procedures include labyrinthectomy, vestibular nerve section, streptomycin perfusion of the labyrinth, and gentamicin or streptomycin instillation into the middle ear.
Cochleosacculotomy for the treatment of Meniere's disease in the elderly patient.