Intratympanic gentamicin therapy for Menière's disease: preliminary comparison of two regimens

Selective chemical ablation of the vestibular endorgan using intratympanic gentamicin is an effective and safe treatment for incapacitating vertigo in patients with unilateral Menière's disease. A major risk of the treatment is sensorineural hearing loss. In this retrospective study, two different regimens of intratympanic gentamicin therapy are compared. In one group, multiple daily doses were administered in hospital over 4 consecutive days. The other group received single treatments at weekly intervals on an outpatient basis, following pretreatment audiometric and clinical assessment. We adopted the weekly protocol to theoretically reduce the incidence of treatment-related hearing loss by a more controlled titration of dosing. Preliminary results indicate that the weekly interval treatment offers equivalent efficacy with considerably less risk to hearing.