27 YEARS EXPERIENCE WITH INTRATYMPANIC AM INOGLYCOSIDE TREATMENT OF MENIERES-DISEASE

Background: Severe unilateral Meniere's disease is successfully treate d intra-tympanically with ototoxic antibiotics. Gentamicin sulfate (Re fobacin(R)) gives the best results. The only disadvantage is that gent amicin may damage hearing in the treated side. Therapy is easier in pa tients with marked hearing loss prior to treatment. Patients and Metho d: Since 1976 we treated 61 patients by injecting 8-12mg Refobacin(R) (0,2-0,3 ml) into the external auditory meatus between two and five ti mes per day. By creating slight pressure (Politzer bag) the liquid is transported into the middle ear via a ventilating tube. From here it p enetrates through the windows. The slightest indication of inner ear r eaction was grounds for immediately terminating treatment. Results: In 54 of our 61 patients (follow-up 2-17 years) we were completely succe ssful. Three further patients continued having very rare and weak spel ls, yet we regard them as being practically healed. We did not succeed in four of our cases. Twenty-nine patients suffered hearing loss. Hea ring! was mostly poor prior to therapy. Conclusions: Transtympanic gen tamicin therapy provides very good results in severe cases of unilater al Meniere's disease. Spells of vertigo and vomiting are controled. We propose individual dosage depending on, hearing threshold and intensi ty of symptoms.