Intratympanic gentamicin treatment for Meniere's disease

The purpose of this study was to evaluate the safety and efficacy of a modified intratympanic gentamicin technique in patients with intractable unilateral or bilateral Meniere's disease.

A retrospective review of 25 consecutive patients who underwent gentamicin treatment for Meniere's disease was conducted between 1992 and 1996. Two separate delivery systems were used during this study, with the last 13 subjects undergoing placement of the new system (flanged polyethylene tubing).

Follow-up averaged 23 months. Absence of vertigo spells was reported in 88%, and substantial control was achieved in 12%. Four of five patients with bilateral disease achieved complete control. Results for the two delivery systems were not significantly different. Absence of ice-water caloric response was seen in 75% (15 of 20) patients. Clinically significant sensorineural hearing loss occurred in 5 (20%) of 25 ears. Nonserviceable hearing developed in only two (8%) patients.

Our results support the previously reported efficacy and relative safety of gentamicin infusion therapy for intractable Meniere's disease. Polyethylene tubing may be more advantageous than T-tube delivery because of anatomic concerns in certain patients.