Evaluation of Two Procedures of Intratympanic Gentamicin Therapy in Meniere’s Disease

The majority of patients with Meniere’s disease (MD) may be managed conservatively with medical therapy. Those who have symptoms refractory to medical management may benefit from surgery. Recently intratympanic gentamicin (IG) administration has gained widespread popularity. Different studies on the effectiveness of treatment with IG, including metaanalysis , document good results in the control of vertigo crises. At the beginning of use, the aim of IG treatment was to abolish vestibular function, hence the name of chemical labyrinthectomy. Later, good results were observed with only partial annulment of vestibular function. For this reason, the quantity of gentamicin is limited at present to effective minimum . Several methods of delivering gentamicin to the inner ear have been described in literature and no consensus has been reached as to which is the most effective. Controversy still exists regarding protocols that use multiple injections from the onset, as opposed to protocols that use multiple injections only if and when needed for recurrent vertigo. Furthermore, the security of administration with regard to the patient’s hearing is not well established. [8-18]