Treatment of Menière's disease with topical gentamicin: a preliminary report.

We evaluated the hypothesis that topical intratympanic gentamicin can relieve the vertigo of disabling Menière's disease, reduce or ablate vestibular caloric excitability, and preserve hearing. Between July 1988 and June 1989, 33 patients were treated in the Dizziness Unit at the Sunnybrook Health Sciences Centre in a prospective controlled trial. This preliminary report presents the results of 29 patients with follow-up averaging 8.3 months and ranging from one to 18 months. All patients had either complete (86.2%) or substantial (13.8%) control of vertigo. Caloric excitability was ablated in 63% and reduced in 25.9% of subjects. Hearing was improved in 35.7%, unchanged in 39.3%, and worse in 25.0% of patients. In this preliminary review, the overall success rate for this treatment is 89.7% if control of vertigo and improvement in disability level are the criteria examined.