TRANSTYMPANIC GENTAMICIN FOR MENIERES-SYNDROME

Objectives: Study the impact of transtympanic gentamicin on patients w ith unilateral Meniere's syndrome. Partial chemical labyrinthectomy is a relatively recent concept for the treatment of Meniere's syndrome. It uses the ototoxic effect of gentamicin to reduce the symptom of ver tigo and maintain cochlear function. Study Design: A prospective study using transtympanic gentamicin was begun in January 1994. Patients se lected had failed medical therapy, but were not incapacitated. Patient s had preinjection audiometric and electronystagmography data. Most ha d an imaging study. All had one injection, about half had more than on e. Patients were seen 1 month after therapy and repeat studies were ob tained. Repeat injection was performed if indicated. Follow-up from th e chart or by telephone was obtained, Data were tabulated using the 19 95 American Academy of Otologaryngology - Head and Neck Surgery guidel ines. Results: Through December 1996 43 patients with unilateral Menie re's syndrome were treated. The pretherapy function level was 3 throug h 5. After therapy the function level was 1 or 2. There was almost no change in cochlear function and no patient became deaf. Many patients had mild ataxia or dysequilibrium during the first 2 weeks following t herapy. Most patients showed some decrease in labyrinthine function me asured on electronystagmography. No attempt was made to ablate labyrin thine function. Seventeen of 18 patients had a vertigo index in the cl ass A or B category after 2 years. Conclusions: Transtympanic gentamic in has become the treatment of choice for patients who fail medical th erapy for Meniere's syndrome at the authors' institution.