[Continuous intratympanic gentamycin infusion in Menière disease]

During the last three years at the ENT Department of the University of Lübeck, patients with Ménière's disease have been fitted with an endaural catheter. A portable infusion pump with a fluid reservoir then supplied the ear being treated with a continuous gentamicin solution. On average, 3 ml of a 0.3% solution was given each day of treatment. In comparison with discontinuous application, this technique proved to be advantageous and therapy was easier to direct. None of the 42 patients undergoing this treatment experienced total hearing loss, as opposed to 3 cases of total deafness under discontinuous treatment. Overall, hearing thresholds remained stable in 23 patients. Thirteen patients suffered hearing losses of up to 20 dB, 4 patients had losses of up to 40 dB, and 2 patients had losses up to 60 dB. In these patients high frequencies were mainly affected. Medical checkups were possible in 24 patients for a period of over 2 years. All of these patients experienced marked decreases in the frequency and intensity of vertigo. Additionally, 14 patients no longer suffered from vertigo, while 8 showed symptoms of incomplete compensation. Two patients still had attacks of vertigo after gentamycin treatment, but these attacks were distinctly less frequent than before. The average dose of gentamicin was 95 mg. In comparison with the control group under discontinuous therapy (325 mg), this dose was clearly smaller.