Chemical and physical labyrinthectomy for Meniere's disease

During the past 30 years, considerable experience has been gained with surgical labyrinthectomy, and consensus has occurred as to the efficacy of these techniques. More recently, over the past 10 years, chemical labyrinthectomy has been of increasing interest to otolaryngologists. The procedure is relatively easy to perform, is accomplished in the office environment, is inexpensive, and usually is not disabling. At the present time, intratympanic application of an ototoxic medication, usually gentamicin, is given in varying doses and numbers of installations. It is given to eliminate disequilibrium in functional ears (both hearing and balance) in order to preserve this function, but also in dysfunctional ears (nonserviceable hearing and site of origin of vertigo) in order to ablate this end organ. It is the purpose of this article to describe briefly the chemical and surgical methods accomplishing such labyrinthectomy, explain the advantages and disadvantages, and address the present consensus as to its effectiveness.