Titration streptomycin therapy in Menière's disease: current concepts

Soon after its discovery, streptomycin sulfate was found to be beneficial in the treatment of tuberculosis. However it also was found to have toxic effects, primarily vestibular and typically sparing the auditory nerve until higher doses were administered. The first reported use of streptomycin in the treatment of vertigo was in 1948. This was soon followed by its use for treating Menière's disease. Although excellent control of vertigo was achieved significant post-treatment oscillopsia was experienced by these completely ablated patients. A protocol of titration streptomycin therapy was established that effectively controls vertigo while decreasing the incidence of oscillopsia. This report presents three patients with Menière's disease treated with this protocol.