The role of dexamethasone or streptomycin perfusion in the treatment of Meniere's disease.

There is ample clinical and animal evidence that, in most patients, Meniere's disease is an immune-mediated disorder in a small, misplaced, malfunctioning endolymphatic sac that causes endolymphatic hydrops, the essential pathology of this disease. If this is so, then the potent anti-inflammatory steroids are the ideal first treatment for Meniere's disease and other immune-mediated diseases of the inner ear, and streptomycin perfusion is the ideal second treatment for those who do not respond to dexamethasone perfusion. The diagnosis, selection of patients, and details of operation with the results are presented. Results have been good with relief of dizzy spells and preservation of hearing in most patients after dexamethasone perfusion and relief of dizzy spells in those patients not responding to the dexamethasone perfusion by streptomycin perfusion.