Selective chemical vestibulectomy. Preliminary results

In an attempt to destroy the peripheral vestibular labyrinth selectively in patients suffering from intractable vertigo as a result of end-stage Ménière's disease, 25 patients underwent selective chemical vestibulectomy between 1989 and 1994. As part of the procedure a certain quantity of streptomycin was placed between the bony and the membranous part of the lateral semicircular canal. The dosage of streptomycin used for successful ablation of vertigo varied between 250 and 100 micrograms. Within 12 months following the procedure all patients experienced a tremendous improvement in their overall condition. In spite of the fact that some patients noted an overall hearing improvement, increased cochlear thresholds were observed in a number of patients, which could not be ignored. The aim of this report is to detail the reliability of control of vertigo, conservation of hearing, and change in disability 12 months after surgery in the 23 patients (of 25) available for follow-up.