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Selective chemical vestibulectomy: preliminary results with human application.
R G Amedee1, C H Norris, J A Risey
1Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA 70112-2699.
Summary
This study details a new surgical approach for Meniere's disease, using streptomycin to block vestibular signals and eliminate vertigo while preserving hearing. Preliminary results in adult clinical trials show promising outcomes for patients with intractable symptoms.
Area of Science:
- Otolaryngology
- Neurosurgery
- Pharmacology
Background:
- Meniere's disease is a chronic inner ear disorder characterized by vertigo, tinnitus, and hearing loss.
- Medically intractable cases often require surgical intervention to manage debilitating symptoms.
Purpose of the Study:
- To evaluate a novel surgical technique for Meniere's disease involving the application of streptomycin.
- To assess the efficacy of this procedure in eliminating vertiginous symptoms and preserving cochlear function.
Main Methods:
- Surgical fenestration of the bony horizontal semicircular canal to access the membranous labyrinth.
- Application of a solid streptomycin flake (125 or 250 mcg) to selectively block vestibular end-organ signals.
- Evaluation of vertiginous symptom elimination and preservation of cochlear thresholds in adult clinical trials.
Main Results:
- The procedure uniformly resulted in the rapid elimination of vertiginous symptoms.
- Calculated doses of streptomycin preserved or improved preoperative cochlear thresholds in some patients.
Conclusions:
- This surgical approach offers a potential solution for medically intractable Meniere's disease.
- Selective vestibular blockade with streptomycin appears effective in managing vertigo while maintaining hearing function.