Symposium on meniere's disease.: Iv. Treatment of meniere's disease by apposition of sodium chloride crystals on the round window

The apposition of a saturated solution of NaCl into the middle ear of a cat or guinea pig provoked a biphasic vestibular spontaneous picture, which is composed of a first phase of “irritative” signs (nystagmus beating toward the injected side, etc.) and a second phase of “paralytic” signs (nystagmus beating toward the non‐injected side, etc.). Starting from these postulates assumed from our experiments, a new attempt in the treatment of Ménière's disease was deemed justified; and the first cases, which were operated upon in 1968, produced favorable results. The results obtained in 145 cases are reported. The principle upon which this new procedure is based can be defined as follows: by introduction of very small, sterilized NaCl crystals, into the round window niche, an outflow of perilymph through the round window membrane is produced. As a result, an acute ionic and osmotic imbalance between perilymph and endolymph is induced, with a subsequent effect on the endolymphatic hydrops. The technique is described.