Gentamicin Therapy in Ménière's Disease

The aim of this article is to verify the efficacy of therapy involving a low dose of gentamicin therapy in patients with “definite” Meniere's disease. Gentamicin was injected directly into the eardrum. The patients then returned two to four weeks after treatment; at that time, an audiogram, bedside tests and compilation of the DHI were carried out. If the patient complained of new attacks of vertigo, a new gentamicin injection was scheduled but always at least a month after the first injection. If the patient complained of dizziness, vestibular rehabilitation was carried out. If there were no new attacks, the patient was scheduled for further check - ups. We do not know why gentamicin is able to control vertiginous crises. We do know that attacks may stop even when the labyrinth is not “dead”. A crisis may be halted because there is damage to the dark cells and not to the neuroepithelium: it would be useless to repeat injections that could damage the hair cells when the target might be the dark cells. Therefore the injection of gentamicin was repeated only if symptoms continued. In this way the risk of a hearing loss was minimal. The low dose technique was found to cause no significant modification in the PTA; on the other hand, there was an effective action on the posterior labyrinth, with good control of vertiginous attacks and a mild improvement in