INTRATYMPANIC GENTAMICIN IN MENIERES-DISEASE

Ninety-three patients with intractable Meniere's disease were treated with gentamicin (Garamycin 40 mg/ml) administered in 1 to 4 transtympa nic injections. The patients were tested at frequent intervals and fol lowed up for 2 years. Before treatment all subjects experienced modera te or severe handicap caused by Meniere's disease. Two years after the treatment, rotatory vertigo was abolished in 81% of subjects, Tumarki n attacks were cured in 60%, and work capacity was severely reduced in 10% and moderately reduced in 17% of subjects. The outcome of the cal oric responses did not correlate with the outcome of the treatment. In logistic regression analysis poor outcome of treatment correlated wit h Tumarkin attacks (odds ratio 5.5). severity of vertigo (odds ratio 3 .8) and gait disorders (odds ratio 2.9). The mean hearing level was si gnificantly affected by the treatment (before, 59.1 dB HL; after, 67.9 dB HL). Ten treated ears became deafened. During follow-up 44 subject s were subjected to retreatment, usually after 6 months. Intratympanic gentamicin treatment is a relatively safe and effective way to treat Meniere's disease. The authors recommended starting with 2 injections and renewing the injections if relapse occurs.