Low-dose intratympanic gentamicin treatment of Menière's disease

To control attacks of vertigo while preserving both hearing and labyrinthine function, low doses of gentamicin were instilled intratympanically in nine patients with intractable unilateral Meniere's disease. Each patient received six instillations of antibiotic of 4 mg each (total dose, 24 mg). Patients were then followed for 2-4 years. Long-term results of treatment are reported according to the American Academy of Otolaryngology-Head and Neck Surgery 1985 criteria. Of the nine cases, three experienced complete control of vertiginous attacks, while six received substantial control. Post-treatment hearing acuity was unaffected, although disability following treatment became worse in one patient, a 66-year-old man. Caloric responses after therapy were absent or severely reduced in three ears, moderately reduced in two ears and unchanged in four ears. In three patients, labyrinthine function was found damaged 4-8 days after administration of the last dose of drug. Overall, intratympanic instillations of low doses of gentamicin in patients with intractable Meniere's disease were found to control vertiginous attacks with less damage to the inner ear function than that reported in the literature.