These are designed to eliminate vertigo, possibly sacrificing hearing. These procedures are appropriate for consideration when medical treatment and vestibular rehabilitation has failed to control vertigo symptoms. By medical treatment we mean a vigorous and informed regimen of treatment supervised by a physician who is familiar with dizziness and its pharmacology. Indications are generally much clearer for destructive treatment than for corrective treatments, and results are better. Vestibular Rehabilitation therapy is appropriate in all patients after destructive treatment.