Special commentary

Abstract

This report represents a hodge podge of the operative results of 13 coinvestigators operating on 23 ears with, among other things, prior endolymphatic shunt operations, stepedectomy for otosclerosis, tympanoplasty for chronic purulent otitis media, and retrolabyrinthine vestibular neurectomy, plus 27 ears in which a shunt was made in the lateral membranous duct. The ears on which these other operations were done were not identified and should not be included in the report. The only significant change, which was an increase or decrease in loss of hearing, was for the group undergoing a shunt of the lateral membranous duct. This is an operation I have not done or recommended for 2 years. Streptomycin perfusion of the labyrinth is an excellent operation for patients in stage III of Meniere's disease, with extensive endolymphatic hydrops, severe nonfluctuating hearing loss, fullness, tinnitus, and poor speech discrimination. Most of these patients recover balance without further dizzy spells on their own following the operation, while some do require professional vestibular rehabilitation. The only other alternative for these patients is vestibular neurectomy, and streptomycin perfusion is, in my opinion, much preferable to this.