Unilateral Meniere’s Disease

Abstract

Meniere’s disease is chronic progressive disease with unclear idiopathic etiologyand symptomatic improvements with treatment. Objectives: To analyze the efficacy of lowdose intratympanic injection of gentamicin for vertigo control in unilateral Meniere’s disease.Study Design: Quasi experimental study. Settings: Department of ENT, PIMS, NESCOM &IMDC Islamabad. Materials & Methods: Gentamicin was used intra tympanically in thismulticentre study of 75 patients over a period of 8.5 years between 1st January 2005 to 30th June2013 in definite Meniere’s disease according to the 1995 Document of American academy ofotolaryngology- Head and Neck Surgery (AAO-HNS).All these centers followed same criteriaand procedures. Single dose of 1 ml Gentamicin solution 40 mg/ml was instilled in the middleear through the grommet under microscope and followed up for 3 months and two years. Thestaging of disease (hearing thresholds) the degree of disability (frequency of attacks per month)and the functional level were assessed before and after treatment. Results: Among 75 patients,41 were female & 34 were males between age ranges of 25 to 70 years. Most of the patients inthe study had stage 2 (23/75) and stage 3 (41/75) Meniere’s disease. About 68(91%) patientswere having good control of vertigo at the end of two year of intratympanic gentamicin withoutany loss of hearing. Conclusion: A single Low dose intratympanic gentamicin is effective incontrolling vertigo in patients with Meniere’s disease with no further deterioration in hearing forat least two years follow up.