Long-term results after interval therapy with intratympanic gentamicin for Menière's disease.
OBJECTIVE
The new single-shot and interval treatment for Menière's disease with gentamicin was designed to avoid cochlear damage during treatment with gentamicin.


METHODS
To date, 90 patients were treated with the single-shot or interval gentamicin therapy. Fifty-seven cases of Menière's disease were followed up prospectively between 2 and 4 years. During one treatment series, a maximum of three intratympanic gentamicin injections within 15 days were applied, each consisting of 0.3 mL (12 mg) of gentamicin (days 1, 8, and 15). Thirty of these 57 patients (53%) needed only one injection to be controlled (single-shot treatment).


RESULTS
Vertigo attacks were completely controlled in 95% and partially controlled in 5%, whereas hearing remained unchanged or even improved. Tinnitus as well as aural fullness were controlled in approximately 50% of the cases.


CONCLUSIONS
Our results with this group of patients after interval-treatment or single-shot application of intratympanic gentamicin demonstrate the effectiveness of this treatment modality with very low side effects, and, although our experience is still limited, it allows for expanding the indication on early cases of Menière's disease before permanent hearing loss occurs. Even cases of bilateral Menière's disease can be treated successfully using this method. Cochleotoxic side effects can be prevented by treatment intervals of 7 days.
Lange
Gert
G
Department of Otorhinolaryngology, University of Mainz, Medical School, Germany.
Maurer
Jan
J
Mann
Wolf
W
D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy*; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome; D014432:Tympanic Membrane
D000900:Anti-Bacterial Agents; D005839:Gentamicins