Intratympanic gentamicin for the treatment of Meniere's disease and other forms of peripheral vertigo.
Titration therapy with intratympanic gentamicin offers class A or B control of vertigo in 87% (range, 75%-100%) of patients with unilateral Ménière's disease. The risk of additional hearing loss is about 21% (range,0-37%). Vertigo may recur, however, in nearly one third of patients over time. These recurrences can also be treated by intratympanic gentamicin with a similar risk of hearing loss. The salient effect of intratympanic gentamicin is probably the reduction of vestibular function through damage to hair cells, but a complete ablation of function does not seem to be necessary for vertigo control.
Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University, 601 North Caroline St., Baltimore, MD 21287, USA. jcarey@jhmi.edu
John
J
Carey
D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000493:pharmacokinetics; D005839:Gentamicins / Q000008:administration & dosage* / Q000493:pharmacokinetics; D006801:Humans; D008575:Meniere Disease / Q000188:drug therapy*; D012405:Round Window, Ear / Q000378:metabolism; D014432:Tympanic Membrane; D014717:Vertigo / Q000188:drug therapy*
D000900:Anti-Bacterial Agents; D005839:Gentamicins