Streptomycin perfusion of the labyrinth through the round window plus intravenous streptomycin.

Streptomycin perfusion of the labyrinth through the round window membrane in the middle ear is a simple, safe, and effective way to stop the dizzy spells, fullness, and tinnitus of Ménière's disease without making the hearing worse. My results with 24 patients in the last 8 months are presented. Although the long-term effect of this operation remains to be seen, my experience with streptomycin perfusion of the labyrinth through the lateral semicircular canal leads me to believe these good results will be maintained in the future. Although the caloric response is not usually eliminated completely in the operated ear, it is reduced enough that the patient no longer has dizzy spells. Because the vestibular receptors are not completely destroyed, and the afferent and efferent nerves coming to and from them are undamaged, the patient compensates after this operation more quickly than when the vestibular receptors are completely destroyed by intramuscular or middle ear aminoglycoside, or when the afferent and efferent nerves of the vestibular receptors are cut as in labyrinthectomy or vestibular neurectomy. Hyaluronan is used to carry the streptomycin into the inner ear because it is known to penetrate the round window easily, and because being hygroscopic, it may reduce the amount of endolymph by osmosis.(ABSTRACT TRUNCATED AT 250 WORDS)