This is a nice summary of the evidence available for the surgical treatments for intractable Meniere’s disease. To summarise, in five-10 years, over 90% of vestibular neurectomy cases, more than 80% of intratympanic gentamycin treatment, and 70-80% of endolymphatic sac surgery achieved complete control of vertigo in comparison with 25-70% of non-operative cases. Hearing was preserved in 60-80% patients who underwent endolymphatic sac surgery, 50-60% patients who underwent neurectomy or gentamycin in comparison with 25-50% on non-operative cases. The author acknowledges that gentamycin is popular due to its convenience and suggests that sac surgery may deserve more consideration having lost credibility from the Danish Sham study.