Clinical forum: a review of intratympanic therapy.

OBJECTIVE

This article provides an overview of the rational basis for the appropriate clinical use of intratympanic aminoglycosides and steroids.

DATA SOURCES: The data sources were relevant English language clinical and basic science publications.

STUDY SELECTION: The most recent publication available for each author or group of original, human, clinical reports about the technique were included.

DATA EXTRACTION: The techniques and results for control of vertigo and hearing loss were compared.

CONCLUSIONS

At least 11 articles have been published that indicate that intratympanic gentamicin treatments control vertigo well and provide acceptable rates of hearing loss. Intratympanic gentamicin should be the initial treatment of choice for unilateral disabling Meniere's disease that has failed medical therapy. The use of intratympanic steroids should remain investigational until more favorable data are available.