[Intratympanic interval therapy of Menière disease with gentamicin with preserving cochlear function]

For the effective treatment of Menière's disease, gentamicin should be administered at most three times: on days 1, 8 and 15. More than 50% ( n=30) of 57 patients seen between 1997 and 2000 only needed a single dose of gentamicin to obtain a sufficient reaction (single shot-therapy). Vertigo attacks were controlled in 95% of our 57 patients and there were no substantial hearing losses. Four patients lost 15 dB. Tinnitus (46%) and ear pressure (69%) could be controlled or improved. The intratympanic injection-technique (single dose=0.3 ml=12 mg) performed under local anaesthesia is simple and superior to any other procedure. The peak concentration of gentamicin is reached after 2-6 days (average 4.6 days). As soon as signs of inner ear reaction are observed, treatment has been effective and must be stopped immediately to avoid over-intoxication and damage to the cochlea.