Unilateral Meniere’s Disease; Intra Tympanic Injection of Low Dose Gentamicin in the Treatment

Abstract

Meniere's disease is chronic progressive disease with unclear idiopathic etiology and symptomatic improvements with treatment. Objectives: To analyze the efficacy of low dose 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 this multicentre study of 75 patients over a period of 8.5 years between 1 st January 2005 to 30 th June 2013 in definite Meniere's disease according to the 1995 Document of American academy of otolaryngology-Head and Neck Surgery (AAO-HNS).All these centers followed same criteria and procedures. Single dose of 1 ml Gentamicin solution 40 mg/ml was instilled in the middle ear through the grommet under microscope and followed up for 3 months and two years. The staging 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 in the study had stage 2 (23/75) and stage 3 (41/75) Meniere's disease. About 68(91%) patients were having good control of vertigo at the end of two year of intratympanic gentamicin without any loss of hearing. Conclusion: A single Low dose intratympanic gentamicin is effective in controlling vertigo in patients with Meniere's disease with no further deterioration in hearing for at least two years follow up.