Professional and Linguistic Assessments Board (PLAB) Practice Exam

What is an additional treatment option for patients with severe Meniere's disease when medical management fails?

1. Transurethral resection

2. Decompression surgery

3. Vestibular rehabilitation

4. Surgical labyrinthectomy

The correct answer is: Surgical labyrinthectomy

In cases of severe Meniere's disease where medical management has not provided relief, surgical labyrinthectomy becomes a viable treatment option. This procedure involves the removal of the inner ear structures associated with hearing and balance. By doing so, it effectively alleviates the debilitating symptoms of Meniere's disease, such as vertigo, at the expense of hearing in the affected ear. This treatment is generally considered for patients who experience frequent, severe episodes of vertigo that significantly impair their quality of life and have not responded to conservative treatments like medication or dietary changes. The surgical intervention aims to disrupt the pathways that cause these debilitating vertiginous attacks, leading to a substantial improvement in quality of life, even though it may result in total hearing loss in one ear. In contrast, other treatment options mentioned do not specifically target the underlying pathology of Meniere's disease or are not appropriate treatments for this condition. For example, transurethral resection is related to urological procedures, and decompression surgery does not address vestibular issues. Vestibular rehabilitation can be beneficial for balance issues but is more suited for those who have not reached a severity level necessitating surgical intervention. Thus, surgical labyrinthectomy stands out as a direct approach