INTRAVENOUS GENTAMICIN TREATMENT IN BILATERAL MENIERES-DISEASE

Background: The treatment of severe forms of bilateral Meniere's disea se remains an especially challenging task. Similar problems also occur in debilitating Meniere's disease in the only hearing ear. The intram uscular titration therapy with streptomycin has been the means of choi ce since 1984 to minimize the risk of total hearing loss in cases of s evere bilateral disease. Method: Since 1989 we have treated six out of 21 cases of bilateral Meniere's disease by intravenous application of 2 x 120 mg gentamicin in Ringer's solution for several days. Addition ally we reported on two cases in 1988. Only minor amounts of gentamici n were applied to sedate the function of both vestibular organs while avoiding damage to the cochlea. Results: In two cases hearing approved approximately about 10 dB, in two cases hearing remained stable, and in two cases hearing worsened about 10 dB. Five of six patients showed minor excitability in caloric tests on both sides, they did not compl ain of vertigo attacks one to five years after therapy. Conclusion: Gi ven that only Very small amounts of gentamicin are applied to sedate t he function of the vestibular organ while causing almost no damage to the cochlea, this method seems to be an excellent means for treatment of bilateral Meniere's disease. Patients do not experience severe prob lems with equilibrium afterwards, and the treatment can be repeated as often as necessary.