High-dose intratympanic gentamicin instillations for treatment of Meniere's disease: long-term results.
CONCLUSIONS
Administration of high-dose gentamicin for intractable Meniere's disease appears to be effective in achieving long-term control of vertigo. However, the safety of this route of administration with respect to the patient's hearing has not yet been sufficiently established.


OBJECTIVE
The study aimed to analyze the long-term results of patients receiving high-dose intratympanic gentamicin (ITG) instillation for refractory Meniere's disease.


METHODS
Fourteen patients with Meniere's disease according to 1995 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guidelines who had failed medical (12 subjects) or surgical (2 subjects) treatment were included. Intratympanic injections of 27 mg/ml gentamicin were performed three times daily for 4 days. Vertigo control, the patients' functional level, and their hearing threshold were all analyzed. Criteria described in 1995 by AAO-HNS were used.


RESULTS
The overall successful vertigo control rate was 92.9% over the 2-year follow-up and 85.7% at long-term follow-up (average 10 years). Hearing level as pure-tone average was worse in four patients (28.5%) after 2 years follow-up and in six patients (42.8%) after long-term follow-up, respectively. Profound sensorineural hearing loss occurred as a result of gentamicin injection in one patient (7%).
Hsieh
Li-Chun
LC
Department of Otolaryngology-Head and Neck Surgery, Mackay Memorial Hospital, Taipei, Taiwan.
Lin
Hung-Ching
HC
Tsai
Hsun-Tien
HT
Ko
Yi-Ching
YC
Shu
Min-Tsan
MT
Lin
Li-Hui
LH
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage / Q000009:adverse effects*; D034381:Hearing Loss / Q000139:chemically induced*; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D011500:Protein Synthesis Inhibitors / Q000008:administration & dosage / Q000009:adverse effects*; D014717:Vertigo / Q000188:drug therapy* / Q000209:etiology
D005839:Gentamicins; D011500:Protein Synthesis Inhibitors