Intratympanic gentamicin therapy for Ménière's disease

Area of Science:

• Otolaryngology
• Neurology
• Pharmacology

Background:

• Meniere's disease is a chronic inner ear disorder characterized by vertigo, hearing loss, and tinnitus.
• Conventional medical therapies often fail to provide adequate symptom control for Meniere's disease.
• Surgical interventions carry significant risks and costs, necessitating exploration of alternative treatments.

Purpose of the Study:

• To assess the efficacy and toxicity of intratympanic gentamicin injections for Meniere's disease.
• To compare outcomes of gentamicin therapy with historical control data.
• To evaluate hearing status, vertigo control, and disability scores post-treatment.

Main Methods:

• Retrospective case series analysis of 28 Meniere's disease patients treated with serial titration of intratympanic gentamicin.
• Comparison with historical controls who received conventional medical or surgical treatment.
• Adherence to American Academy of Otolaryngology--Head and Neck Surgery 1985 criteria for outcome reporting.

Main Results:

• Significant vertigo control (complete or substantial) achieved in 91% of patients.
• Hearing loss observed in approximately one-third of patients, similar to historical treatment outcomes.
• Ototoxicity, specifically high-frequency hearing loss, was more prevalent in patients with better pre-treatment hearing thresholds.

Conclusions:

• Intratympanic gentamicin therapy offers a highly effective and less invasive method for managing Meniere's disease vertigo.
• This treatment provides substantial vertigo control with a lower risk profile compared to surgical options.
• Gentamicin therapy represents a valuable therapeutic strategy for patients refractory to conventional Meniere's disease treatments.