Intratympanic gentamicin therapy for intractable Ménière's disease.
CONCLUSIONS
Intratympanic gentamicin treatment using a low dose of gentamicin (approximately 21-24 mg per injection) applied at intervals of a minimum of 27 days, has been shown to be a successful treatment of vertigo.


OBJECTIVE
The objective of this analysis was to evaluate the efficacy and side effects of intratympanic injections of gentamicin as treatment of intractable unilateral Ménière's disease.


METHODS
This was a retrospective study in which 57 patients treated with intratympanic gentamicin for Ménière's disease were analysed. Patients received between 1 and 10 intratympanic injections of gentamicin in an outpatient setting.


RESULTS
Six months after treatment, overall complete or substantial vertigo control was reported by 80.7% of our patients (VCC class A, 61.4%; class B, 19.3%). Unilateral caloric weakness increased from 50.1% to 79.8% after treatment, and complete caloric areflexia (30 degrees C and 44 degrees C) was induced in 38.6%. In this study hearing worsened (> 10 dB = SNHL) in only 15.8% of our patients (range 10-29 dB) and loss of word recognition (WR) scores worsened (>15%) in 31% of the patients. Only 1 injection was necessary in 49.1% of the patients, the remaining 50.9% needed 2, 3, 4, 6 or 10 injections, always with a time interval of a minimum of 27 days.
De Beer
Lieke
L
Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital Maastricht, Maastricht, The Netherlands.
Stokroos
Robert
R
Kingma
Herman
H
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001301:Audiometry, Pure-Tone; D002150:Caloric Tests; D004334:Drug Administration Schedule; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use*; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000453:epidemiology; D006801:Humans; D007267:Injections; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D008875:Middle Aged; D012021:Reflex, Abnormal / Q000187:drug effects; D012189:Retrospective Studies; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014432:Tympanic Membrane
D000900:Anti-Bacterial Agents; D005839:Gentamicins