gested that drop attacks can occur with other peripheral vestibular disorders in addition to Meniere's syndrome {b]. He provided minimal details regarding these patients, however.
Finally, although our data do not allow us to speculate on the effectiveness of different types of treatments for drop attacks associated with Meniere's syndrome, we cannot agree with Black and associates that the treatment of choice is surgery. As did Janzen and Russell {3}, we found that most patients have a spontaneous remission, regardless of the treatment. In a few patients the drop attacks are either so dangerous or intractable that surgical intervention is warranted. Assuming that the diagnosis of unilateral Meniere's syndrome is well documented, one can anticipate that the drop attacks will stop after surgery. Regarding the type of surgery, Black and associates {2) and Janzen and Russell {3} agreed that endolymphatic shunt operations are not effective for controlling the drop attacks associated with Meniere's syndrome. Vestibular nerve section is the procedure of choice in patients with serviceable hearing, whereas a labyrinthectomy might be considered in patients with profound hearing loss [2f.
Odkvist and Bergenius {9} suggested that intratympanic injection of gentarnycin was equally effective in stopping the drop attacks associated with Meniere's syndrome.