It is not my intention here to discuss in full detail the various pertinent questions relating to this important problem or to describe completely the techniques by which the labyrinth can be destroyed. However, on the basis of personal experiences, I will endeavor to set down some of the pertinent facts regarding destructive therapy.
A sudden attack of severe vertigo accompanied by nausea and vomiting is a terrifying experience. When the episodes in Ménière's disease recur frequently, patients are fearful of having attacks while at work or on the street. At this stage, they are incapacitated and willing to make some sacrifice to acquire relief of symptoms. Before destructive therapy can be advised, it is essential that the following criteria for conclusive diagnosis be met: (1) attacks of vertigo and vomiting; (2) perceptive type hearing loss manifested by threshold loss for bone and air conduction (Fig. 1); (3) loudness recruitment in the involved ear, and (4) diminution of caloric response in the in volved ear.
SCHUKNECHT HF. Destructive Therapy for Ménière's Disease. AMA Arch Otolaryngol. 1960;71(3):562–572. doi:10.1001/archotol.1960.03770030204031
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