Intratympanic Gentamicin Injection in Ménière’s Disease: Our Ten Years’ Experience and Outcomes

Author(s): Barbara Filosa, Antonio Trusio, Generoso De Cristofaro, Pasquale Marra, Giuseppe Malafronte

Objective: The aim of our study is to evaluate the effectiveness of intratympanic gentamicin injection (ITG) on vertigo control with reduced doses and its hearing effects.

Materials and Method: The study was conducted at Otolaryngology Department of AORN “S.G. Moscati” between January 2005 and January 2015 on 72 patients with disabling unilateral Meniere’s disease. We use 0.2-0.3 mL of gentamicin sulfate at a concentration of 40mg/ml, injected into the affected ear through the posterior-inferior quadrant of the tympanic membrane. The procedure was carried out for three following days. Main outcome measures: vertigo control and hearing threshold changes after ITG treatment.

Results: In 98.6% of the patients(n=71) the ITG produced the full remission of the vertiginous symptoms. In 91.6% of cases(n=66) a single treatment (three consequent injections) was sufficient to control vertigo, in 5.5% of cases(n=4) two treatments were necessary to control vertigo and in 1.3% of patients(n=1) three treatments were necessary to control vertigo. In no case we have had hearing loss after ITG procedure. The pre-treatment pure tone average was 48db. The post-treatment pure tone average was 49.2db. This difference was no statistical difference.

Conclusion: In this study we reported high vertigo control, long follow-up and no case of significant hearing worsening. We consider the three injections in the following three days with low doses of gentamicin a safe and valid treatment for Meniere’s disease.