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Outcomes in the use of intra-tympanic gentamicin in the treatment of Ménière's disease

Published online by Cambridge University Press:  25 November 2005

Sean Flanagan ,
Payal Mukherjee  and
John Tonkin
Sean Flanagan
Affiliation:
Department of Otolaryngology, St Vincent's Hospital, Sydney, New South Wales, Australia
Payal Mukherjee
Affiliation:
Department of Otolaryngology, St Vincent's Hospital, Sydney, New South Wales, Australia
John Tonkin
Affiliation:
Department of Otolaryngology, St Vincent's Hospital, Sydney, New South Wales, Australia
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Abstract

The pathogenesis of Ménière's disease is associated with a disorder of ionic homeostasis, with the pathologic correlate being endolymphatic hydrops. Despite uncertainty as to its particular mode of action, it is accepted wisdom that intra-tympanic gentamicin has a definite therapeutic role in the control of symptoms in patients who fail to respond to medical therapy. This study reports an evaluation of the efficacy of intra-tympanic gentamicin in the treatment of Ménière's disease and also presents a simple, reliable, safe method of administering gentamicin for this purpose.

A retrospective review of 56 patients undergoing intra-tympanic gentamicin treatment for Ménière's disease was conducted. Response to treatment was analysed using a patient survey and examination of pure-tone averages. An overall significant improvement in vertigo symptoms of 81.3 per cent was found. There was a 21.4 per cent rate of significant hearing loss, defined as greater than 10 dB, with an average loss in this group of 18.5 dB. A single dose of gentamicin applied directly to the round window resulted in a high rate of control of vertigo, with acceptably low rates of hearing loss.

Keywords

Ménière's DiseaseGentamicinMiddle EarRound Window
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 120 , Issue 2 , February 2006 , pp. 98 - 102
Copyright
© 2005 JLO (1984) Limited

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Footnotes

This paper was previously presented at the Australasian Society of Otolaryngology and Head and Neck Surgery National Conference, May 2003, Cairns, Queensland, Australia.