Selective vestibular ablation by intratympanic gentamicin in patients with unilateral active Ménière's disease: a prospective, double-blind, placebo-controlled, randomized clinical trial.
OBJECTIVE
To establish the efficacy of intratympanic gentamicin treatment in patients with unilateral Ménière's disease.


METHODS
This was a prospective, double-blind, randomized clinical trial of intratympanic gentamicin versus intratympanic buffer solution (placebo) in patients with established active Ménière's disease in the affected ear. Outcome measures included the number of vertiginous spells, degree of sensorineural hearing loss, labyrinthine function and labyrinthine asymmetry.


RESULTS
Topical gentamicin provided a significant reduction in the number of vertiginous spells, although a "placebo effect" was also observed. Sensorineural hearing loss did not occur in the gentamicin group, although some deterioration occurred in the placebo group.


CONCLUSIONS
Intratympanic gentamicin is a safe and efficient treatment for the vertiginous spells associated with Ménière's disease. When applied early in the course of the disease, it may prevent some of the sensorineural hearing deterioration associated with it.
Stokroos
Robert
R
Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital Maastricht, The Netherlands. rsto@skno.azm.nl
Kingma
Herman
H
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001301:Audiometry, Pure-Tone; D001309:Auditory Threshold / Q000187:drug effects*; D004311:Double-Blind Method; D005069:Evaluation Studies as Topic; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy*; D008875:Middle Aged; D011446:Prospective Studies
D000900:Anti-Bacterial Agents; D005839:Gentamicins