title: Intratympanic gentamicin for Ménière's disease or syndrome.
abstract: BACKGROUND
  Ménière's disease is characterised by three major symptoms: vertigo, deafness and tinnitus, which may be accompanied by aural fullness, all of which are discontinuous and variable in intensity. While discontinuous, these symptoms are synchronous. Intratympanic application of gentamicin, an ototoxic aminoglycoside, is a relatively new ablative treatment for vertigo in Ménière's disease with promising results.
  
  
  OBJECTIVE
  To assess the effectiveness of intratympanic gentamicin in the treatment of vertigo in Ménière's disease.
  
  
  METHODS
  We searched the Cochrane Ear, Nose and Throat Disorders Group Trials Register; the Cochrane Central Register of Controlled Trials (CENTRAL); PubMed; EMBASE; CINAHL; Web of Science; BIOSIS Previews; Cambridge Scientific Abstracts; ISRCTN and additional sources for published and unpublished trials. The date of the most recent search was 30 June 2010.
  
  
  METHODS
  All randomised or quasi-randomised controlled trials of intratympanic gentamicin versus placebo, or versus another treatment for Ménière's disease.
  
  
  METHODS
  Two review authors independently assessed trial quality and extracted data. We contacted study authors for further information.
  
  
  RESULTS
  We identified two trials, involving 50 participants, which fulfilled the inclusion criteria. Both of these trials are prospective, double-blind, placebo-controlled randomised clinical trials on the effect of intratympanic gentamicin on vertigo complaints. Both of these trials found a significant reduction in vertigo complaints in the gentamicin group when compared to the placebo group. Due to clinical heterogeneity we could not perform a meta-analysis.
  
  
  CONCLUSIONS
  Based on the results of the two included studies, intratympanic gentamicin seems to be an effective treatment for vertigo complaints in Ménière's disease, but carries a risk of hearing loss.
authors.affiliation: ENT Surgery, University Medical Centre Utrecht, Heidelberglaan 100, Utrecht, Netherlands, 3584 CX.
authors.forename: Bas
authors.initials: B
authors.lastname: Pullens
authors.forename: Peter Paul
authors.initials: PP
authors.lastname: van Benthem
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D004432:Ear, Middle; D005839:Gentamicins / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008575:Meniere Disease / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D013577:Syndrome; D014717:Vertigo / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins