Intratympanic gentamicin titration therapy for intractable Meniere's disease

Area of Science:

• Otolaryngology
• Neurology
• Vestibular System

Background:

• Meniere's disease is a chronic inner ear disorder characterized by vertigo, tinnitus, hearing loss, and aural fullness.
• Intractable unilateral Meniere's disease presents significant management challenges.
• Intratympanic gentamicin therapy is a potential treatment option for managing severe Meniere's disease symptoms.

Purpose of the Study:

• To evaluate the efficacy of intratympanic gentamicin titration therapy in managing intractable unilateral Meniere's disease.
• To assess the associated morbidity, particularly hearing loss, following this treatment.

Main Methods:

• Retrospective chart review and patient interviews were conducted.
• Eighty-three patients with unilateral Meniere's disease received weekly intratympanic gentamicin injections.
• Vertigo control, hearing status, disability ratings, tinnitus, and caloric responses were assessed before and after therapy.

Main Results:

• Eighty-four percent of patients achieved complete vertigo control, with an additional 6% showing substantial improvement.
• A small percentage (17%) experienced a clinically significant hearing reduction, while 26% showed hearing improvement.
• No statistically significant overall change in hearing parameters was observed, and no patients had extreme hearing loss.

Conclusions:

• Intratympanic gentamicin titration therapy is a highly effective treatment for vertigo in Meniere's disease.
• The therapy demonstrates a low incidence of significant hearing loss, making it a favorable option for patients with intractable symptoms.