Intratympanic gentamicin injections for the treatment of Ménière's disease

Abstract

Objective To assess the success rate and complications of treatment with injections of intratympanic gentamicin to the middle ear of patients with Ménière's disease. Study Design Case series with chart review. Setting A tertiary otologic private ENT clinic. Subjects and Methods Patients with Ménière's disease, who had not responded to medical treatment. Included in the sample were patients with Ménière's disease who had been treated with injections of gentamicin into the middle ear. After each gentamicin application, patients were monitored for their symptoms and hearing. If symptoms persisted, they received another intratympanic injection of gentamicin. This method is referred to as the variable titration method. A retrospective chart review was performed, and questionnaires were used to assess hearing, functional status, tinnitus, ear fullness sensation, and the control of vertigo attacks in response to treatment. Results Nineteen patients were sampled. Eighteen patients (94%) had complete or substantial control of vertigo. Five patients (26%) had worse hearing results on their post-treatment audiogram, averaging 13 dB hearing loss (range, 5-25 dB). In response to the questionnaires, all patients reported a significant improvement in the quality of life after treatment. Conclusion The treatment was found to be highly effective. The variable titration method of injection prevents unnecessary injections for patients whose symptoms have already subsided.