Sd. Rauch et Jg. Oas, INTRATYMPANIC GENTAMICIN FOR TREATMENT OF INTRACTABLE MENIERES-DISEASE - A PRELIMINARY-REPORT, The Laryngoscope, 107(1), 1997, pp. 49-55
Topical administration of aminoglycoside antibiotics in the middle ear
can achieve ''chemical labyrinthectomy'' in patients with intractable
Meniere's disease. Herein we report our results of intratympanic gent
amicin therapy in 21 patients using two different dosing protocols, tw
ice weekly and twice daily (b.i.d.). Both hearing and vertigo outcome
were evaluated. Complete control of episodic vertigo was achieved init
ially in 20 of 21 patients (95.2%). However, 6 of 20 responders (30%)
developed relapsing symptoms within 12 months. Retreatment was success
ful in 75% of these patients, Overall, hearing was preserved or improv
ed in 62% of cases, worse in 24%, and not yet tested in 14%. When the
cumulative dose of gentamicin was less than or equal to 4 injections i
n the first week, only 1 of 14 (7.1%) lost hearing. Intratympanic gent
amicin offers better risk/benefit outcome than other invasive therapie
s for intractable Meniere's disease.