Selective chemical vestibulectomy: preliminary results with human application.

The involved membranous labyrinth of patients with medically intractable Meniere's disease is being accessed by means of a fenestration of the bony horizontal semicircular canal in preparation for the application of a 125 or 250 mcg flake of solid streptomycin. Sensory information originating in the affected vestibular end organ is selectively blocked from reaching the central nervous system. This uniformly results in the rapid elimination of vertiginous symptoms, and at these calculated doses yields preservation of (or in some cases improvement in) preoperative cochlear thresholds. The rationale for this procedure, as detailed in earlier investigations of animals, will be briefly reviewed before highlighting our preliminary results in adult clinical trials.