Objective: This study aimed to assess the efficacy and morbidity of intraty
mpanic gentamicin titration therapy on patients with intractable unilateral
Meniere's disease.
Study Design: The study design was a retrospective chart review and patient
interviews.
Setting: The study was conducted at a tertiary referral ambulatory dizzines
s clinic at the London Health Sciences Centre, University Campus, from July
1992 to June 1997.
Intervention: Eighty-three patients received weekly intratympanic gentamici
n injections in their diseased ear. Treatments were terminated after four i
njections or sooner if patients met clinical or audiologic criteria. Sixty-
eight patients were available for detailed follow-up.
Main Outcome Measures: Vertigo frequency, hearing status, personal disabili
ty ratings, tinnitus level, and caloric responses before and after gentamic
in therapy were measured.
Results: Eighty-four percent of patients showed complete, and an additional
6% showed substantial, vertigo control. At 24 months, 17% of patients demo
nstrated a clinically significant (10-dB) reduction in hearing, but 26% sho
wed a significant hearing improvement. Overall, the group showed no combine
d statistically significant changes in any of the hearing parameters. No pa
tients had an "extreme" drop in hearing (>30 dB).
Conclusions: Intratympanic gentamicin titration therapy provides excellent
vertigo control with a low incidence of hearing loss.