INTRATYMPANIC GENTAMICIN FOR TREATMENT OF INTRACTABLE MENIERES-DISEASE - A PRELIMINARY-REPORT

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.