Gentamicin injections for Ménière disease: comparison of subjective and objective end points.

This retrospective study reports the overall efficacy and comparative results of intratympanic gentamicin injections for disabling vertigo episodes. All patients received weekly injections for diagnosed Ménière disease. In Group 1 (81 patients), treatment end points were determined by subjective complaints of imbalance, with resolution of vertigo. In Group 2 (23 patients), treatment end points were determined when 2 or more values of nystagmus were demonstrated. (Group 2 patients were assessed before initiation of therapy for head-shaking, head-thrust, and spontaneous nystagmus using infrared video goggles.) After the final injection, all patients had audiograms and balance and oculomotor retraining. Gentamicin therapy was determined to be successful based on 3-month post-therapy findings of vertigo resolution, stable hearing, normalized nystagmus, and functional balance.