title: Intratympanic gentamicin titration therapy for intractable Meniere's disease.
abstract: OBJECTIVE
  This study aimed to assess the efficacy and morbidity of intratympanic gentamicin titration therapy on patients with intractable unilateral Meniere's disease.
  
  
  METHODS
  The study design was a retrospective chart review and patient interviews.
  
  
  METHODS
  The study was conducted at a tertiary referral ambulatory dizziness clinic at the London Health Sciences Centre, University Campus, from July 1992 to June 1997.
  
  
  METHODS
  Eighty-three patients received weekly intratympanic gentamicin injections in their diseased ear. Treatments were terminated after four injections or sooner if patients met clinical or audiologic criteria. Sixty-eight patients were available for detailed follow-up.
  
  
  METHODS
  Vertigo frequency, hearing status, personal disability ratings, tinnitus level, and caloric responses before and after gentamicin therapy were measured.
  
  
  RESULTS
  Eighty-four percent of patients showed complete, and an additional 6% showed substantial, vertigo control. At 24 months, 17% of patients demonstrated a clinically significant (10-dB) reduction in hearing, but 26% showed a significant hearing improvement. Overall, the group showed no combined statistically significant changes in any of the hearing parameters. No patients had an "extreme" drop in hearing (>30 dB).
  
  
  CONCLUSIONS
  Intratympanic gentamicin titration therapy provides excellent vertigo control with a low incidence of hearing loss.
authors.affiliation: Department of Otolaryngology, University of Western Ontario, London, Canada.
authors.forename: J T
authors.initials: JT
authors.lastname: Atlas
authors.forename: L S
authors.initials: LS
authors.lastname: Parnes
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002150:Caloric Tests; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005839:Gentamicins / Q000627:therapeutic use*; D006801:Humans; D007267:Injections; D008297:Male; D008575:Meniere Disease / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy*; D008875:Middle Aged; D012189:Retrospective Studies; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014717:Vertigo / Q000150:complications / Q000175:diagnosis
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins