Low-dose intratympanic gentamicin treatment for dizziness in Ménière's disease

J Otolaryngol. 2000 Feb;29(1):35-9.

Abstract

Objective: Intratympanic gentamicin is used to control dizziness of Ménière's disease, with a low rate of morbidity and a high success rate. We aimed to develop a new technique and schedule of therapy using a lower dose.

Design: A retrospective chart review in Ménière's disease patients treated for intractable dizziness.

Setting: A tertiary/quaternary care outpatient setting.

Methods: Patients were administered intratympanic gentamicin using a low-dose protocol on 2 successive days and evaluated with pre- and post-treatment audiovestibular assessment.

Main outcome measures: Standard evaluation methods of audiovestibular function measured pre- and postfunction of hearing and balance to determine the effects of treatment and morbidity in the form of hearing loss. A telephone follow-up survey was also undertaken.

Results: Patients reported satisfactory control of dizziness, with little morbidity in the form of hearing loss. We also found that the use of a myringotomy tube could be precluded. Post-treatment symptoms of imbalance reported by patients settled as patients compensated. In a telephone survey conducted some years after treatment, patient satisfaction was found to be high.

Conclusions: This two-dose regime was shown to be effective in controlling dizzy spells. In patients refractory to the initial two-dose treatment, a follow-up course of treatment usually proved effective. Long-term follow-up of patients seems to show that failure of treatment usually occurs within the first few months, and that symptoms, once controlled, rarely recur.

MeSH terms

  • Administration, Topical
  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use*
  • Dizziness / drug therapy*
  • Ear, Middle
  • Female
  • Follow-Up Studies
  • Gentamicins / administration & dosage
  • Gentamicins / therapeutic use*
  • Hearing / drug effects
  • Hearing Loss / therapy
  • Humans
  • Interviews as Topic
  • Longitudinal Studies
  • Male
  • Meniere Disease / drug therapy*
  • Middle Aged
  • Patient Satisfaction
  • Postural Balance / drug effects
  • Retrospective Studies
  • Sensation Disorders / therapy
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Gentamicins