Intratympanic gentamicin therapy for intractable Ménière's disease

Abstract

Conclusions. Intratympanic gentamicin treatment using a low dose of gentamicin (∼21–24 mg per injection) applied at intervals of a minimum of 27 days, has been shown to be a successful treatment of vertigo. Objectives. The objective of this analysis was to evaluate the efficacy and side effects of intratympanic injections of gentamicin as treatment of intractable unilateral Ménière's disease. Patients and methods. This was a retrospective study in which 57 patients treated with intratympanic gentamicin for Ménière's disease were analysed. Patients received between 1 and 10 intratympanic injections of gentamicin in an outpatient setting. Results. Six months after treatment, overall complete or substantial vertigo control was reported by 80.7% of our patients (VCC class A, 61.4%; class B, 19.3%). Unilateral caloric weakness increased from 50.1% to 79.8% after treatment, and complete caloric areflexia (30°C and 44°C) was induced in 38.6%. In this study hearing worsened (>10dB = SNHL) in only 15.8% of our patients (range 10–29 dB) and loss of word recognition (WR) scores worsened (>15%) in 31% of the patients. Only 1 injection was necessary in 49.1% of the patients, the remaining 50.9% needed 2, 3, 4, 6 or 10 injections, always with a time interval of a minimum of 27 days.