Streptomycin treatment for Meniere's disease

Area of Science:

• Otolaryngology
• Neurology
• Pharmacology

Background:

• Meniere's disease is a chronic inner ear disorder.
• Current treatments for Meniere's disease include surgical and non-surgical interventions.

Purpose of the Study:

• To evaluate the efficacy of streptomycin sulfate in treating Meniere's disease over a 10-year period.
• To compare different streptomycin administration methods: surgical ablation, intratympanic injection, and low-dose intramuscular treatment.

Main Methods:

• Retrospective analysis of 22 patients with Meniere's disease treated with streptomycin sulfate.
• Methods included Schuknecht vestibular ablation (bilateral and unilateral), intratympanic injections, and low-dose intramuscular streptomycin.
• Outcomes assessed included vertigo relief, hearing preservation, and side effects like ataxia and oscillopsia.

Main Results:

• Vestibular ablation provided vertigo relief but caused temporary ataxia and oscillopsia; hearing improved in ~30% but was often temporary.
• Intramuscular streptomycin ablation in the only hearing ear is recommended over surgery, preserving hearing.
• Low-dose intramuscular streptomycin showed promise for symptom relief and potential hearing improvement without severe side effects.

Conclusions:

• Intramuscular streptomycin is a viable alternative to surgery for Meniere's disease, especially in the only hearing ear.
• Intratympanic streptomycin delivery requires further refinement for dose control.
• Low-dose streptomycin may become a preferred treatment for Meniere's disease due to its efficacy and manageable side effect profile.