title: Intratympanic gentamicin in Meniere's disease.
abstract: Ninety-three patients with intractable Meniere's disease were treated with gentamicin (Garamycin 40 mg/ml) administered in 1 to 4 transtympanic injections. The patients were tested at frequent intervals and followed up for 2 years. Before treatment all subjects experienced moderate or severe handicap caused by Meniere's disease. Two years after the treatment, rotatory vertigo was abolished in 81% of subjects, Tumarkin attacks were cured in 60%, and work capacity was severely reduced in 10% and moderately reduced in 17% of subjects. The outcome of the caloric responses did not correlate with the outcome of the treatment. In logistic regression analysis poor outcome of treatment correlated with Tumarkin attacks (odds ratio 5.5), severity of vertigo (odds ratio 3.8) and gait disorders (odds ratio 2.9). The mean hearing level was significantly affected by the treatment (before, 59.1 dB HL; after, 67.9 dB HL). Ten treated ears became deafened. During follow-up 44 subjects were subjected to retreatment, usually after 6 months. Intratympanic gentamicin treatment is a relatively safe and effective way to treat Meniere's disease. The authors recommended starting with 2 injections and renewing the injections if relapse occurs.
authors.affiliation: Department of Otolaryngology, University Hospital of Helsinki, Finland.
authors.forename: S
authors.initials: S
authors.lastname: Kaasinen
authors.forename: I
authors.initials: I
authors.lastname: Pyykkö
authors.forename: H
authors.initials: H
authors.lastname: Ishizaki
authors.forename: H
authors.initials: H
authors.lastname: Aalto
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001301:Audiometry, Pure-Tone; D016009:Chi-Square Distribution; D004584:Electronystagmography; D005081:Exercise Therapy; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D016015:Logistic Models; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy* / Q000503:physiopathology; D008875:Middle Aged; D016017:Odds Ratio; D011187:Posture; D011446:Prospective Studies; D012720:Severity of Illness Index; D014432:Tympanic Membrane; D014717:Vertigo / Q000188:drug therapy
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins