Intratympanic gentamicin titration therapy for intractable Meniere's disease.

OBJECTIVE

This study aimed to assess the efficacy and morbidity of intratympanic 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 dizziness clinic at the London Health Sciences Centre, University Campus, from July 1992 to June 1997.

INTERVENTION: Eighty-three patients received weekly intratympanic gentamicin injections in their diseased ear. Treatments were terminated after four injections 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 disability ratings, tinnitus level, and caloric responses before and after gentamicin 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 demonstrated a clinically significant (10-dB) reduction in hearing, but 26% showed a significant hearing improvement. Overall, the group showed no combined statistically significant changes in any of the hearing parameters. No patients had an "extreme" drop in hearing (>30 dB).

CONCLUSIONS

Intratympanic gentamicin titration therapy provides excellent vertigo control with a low incidence of hearing loss.