LONG-TERM RESULTS OF LOW-DOSE INTRAMUSCULAR STREPTOMYCIN FOR MENIERES-DISEASE

The initial results of partial ablation of vestibular function are evi dent to control vertigo attacks and stabilize hearing as well as to re duce the severity of ataxia. The purpose of this study is to observe t he long-term results of low dose intramuscular streptomycin in the tre atment of bilateral Meniere's disease. Eleven patients with disabling bilateral Meniere's disease were treated with low doses of intramuscul ar streptomycin (20-40 g, mean = 25 g). Follow-up was 5-12 years (mean = 8 yr). All 11 patients achieved relief of their disabling vertigo. One patient had recurrent vertigo 1 year after treatment and streptomy cin perfusion of the labyrinth was performed subsequently. Four patien ts reported feeling slightly off balance during follow-up. None experi enced oscillopsia in this series. In the entire group of 11 patients ( 22 ears), hearing was unchanged in 17 ears, improved in two and worse in three. A hearing threshold of <30 dB was found in two ears before a nd two after treatment; 30-60 dB was found in seven ears before and si x after treatment; and >60 dB was found in 13 ears before and 14 after treatment. The mean PTA of the 22 ears was 58 dB before and 65.5 dB a fter treatment. The mean speech discrimination scores were 61.4 percen t before and 51.3 percent after treatment. The long-term results sugge st that partial ablation of vestibular function by streptomycin has lo ng-lasting effects of controlling vertigo attacks, stabilizing hearing , and reducing the severity of ataxia. Administration of low doses of intramuscular streptomycin is the treatment of choice for bilateral Me niere's disease.