Abstract
Office-based intratympanic gentamicin injections are an important treatment modality for the management of refractory vestibular symptoms in patients suffering from Meniere's disease. Taking advantage of gentamicin's preferential vestibulotoxicity, chemical labyrinthectomy can be performed. Preprocedural counseling is necessary to ensure that patients have failed symptom control with maximal, non-ablative treatment options, including diet/lifestyle modification, diuretics and intratympanic steroid injections. Additionally, they should be familiar with the risk of hearing loss, and the likely continuation of non-vestibular aural symptoms. With appropriate dosing and monitoring, relief from vestibular symptoms may be achieved in up to 90% of patients while limiting risk to hearing.
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