Low-dose intratympanic gentamicin treatment for dizziness in Ménière's disease.
OBJECTIVE
Intratympanic gentamicin is used to control dizziness of Ménière's disease, with a low rate of morbidity and a high success rate. We aimed to develop a new technique and schedule of therapy using a lower dose.


METHODS
A retrospective chart review in Ménière's disease patients treated for intractable dizziness.


METHODS
A tertiary/quaternary care outpatient setting.


METHODS
Patients were administered intratympanic gentamicin using a low-dose protocol on 2 successive days and evaluated with pre- and post-treatment audiovestibular assessment.


METHODS
Standard evaluation methods of audiovestibular function measured pre- and postfunction of hearing and balance to determine the effects of treatment and morbidity in the form of hearing loss. A telephone follow-up survey was also undertaken.


RESULTS
Patients reported satisfactory control of dizziness, with little morbidity in the form of hearing loss. We also found that the use of a myringotomy tube could be precluded. Post-treatment symptoms of imbalance reported by patients settled as patients compensated. In a telephone survey conducted some years after treatment, patient satisfaction was found to be high.


CONCLUSIONS
This two-dose regime was shown to be effective in controlling dizzy spells. In patients refractory to the initial two-dose treatment, a follow-up course of treatment usually proved effective. Long-term follow-up of patients seems to show that failure of treatment usually occurs within the first few months, and that symptoms, once controlled, rarely recur.
Longridge
N S
NS
Department of Surgery, University of British Columbia, Vancouver.
Mallinson
A I
AI
D000287:Administration, Topical; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D004244:Dizziness / Q000188:drug therapy*; D004432:Ear, Middle; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use*; D006309:Hearing / Q000187:drug effects; D034381:Hearing Loss / Q000628:therapy; D006801:Humans; D007407:Interviews as Topic; D008137:Longitudinal Studies; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy*; D008875:Middle Aged; D017060:Patient Satisfaction; D004856:Postural Balance / Q000187:drug effects; D012189:Retrospective Studies; D012678:Sensation Disorders / Q000628:therapy; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D005839:Gentamicins