LOW-DOSE INTRATYMPANIC GENTAMICIN TREATMENT OF MENIERES-DISEASE

To control attacks of vertigo while preserving both hearing and labyri nthine function, low doses of gentamicin were instilled intratympanica lly in nine patients with intractable unilateral Meniere's disease. Ea ch patient received six instillations of antibiotic of 4 mg each (tota l dose, 24 mg). Patients were then followed for 2-4 years. Long-term r esults of treatment are reported according to the American Academy of Otolaryngology-Head and Neck Surgery 1985 criteria. Of the nine cases, three experienced complete control of vertiginous attacks, while six received substantial control. Post-treatment hearing acuity was unaffe cted, although disability following treatment became worse in one pati ent, a 66-year-old man. Caloric responses after therapy were absent or severely reduced in three ears, moderately reduced in two ears and un changed in four ears. In three patients, labyrinthine function was fou nd damaged 4-8 days after administration of the last dose of drug. Ove rall, intratympanic instillations of low doses of gentamicin in patien ts with intractable Meniere's disease were found to control vertiginou s attacks with less damage to the inner ear function than that reporte d in the literature.