SURGERY AND NEUROLOGY OF MÉNIÈRE'S DISEASE<subtitle>I. Role of the Chorda Tympani Nerve in Tinnitus, Vertigo, and Deafness</subtitle>

THE SYNDROME of vertigo, tinnitus, and deafness (Ménière's syndrome) is a matter of concern to every general practitioner, otologist, and neuropsychiatrist. The widespread occurrence of this disease, and its crippling effect in men and women of all ages and of all economic groups, makes it a serious national problem. The solution of this problem, it seems, requires a basic revision of certain physiologic concepts important to medical science as a whole. Although a sympathetic-parasympathetic disbalance affecting the capillary circulation of the internal ear is postulated as the etiology of Ménière's disease, patients continue to be subjected to intracranial section of the eighth nerve and to destruction of the entire labyrinth (cochlear and vestibular) on the affected side— procedures concerned purely with symptomatic relief. Over 30% of patients subjected to this surgery are not relieved of the disabling tinnitus and sometimes not altogether of the vertigo. Furthermore, one must not overlook