Low Dose Transtympanic Gentamicin Treatment for Intractable Meniere’s Disease: A Prospective Study
Lalida Kasemsuwan MD*, Chanchai Jariengprasert MD*, Suwimol Ruencharopen MA*, Pisamai Orathai PhD**
Affiliation : * Otolaryngology Department, Faculty of Medicine, Ramathibodi Hospital ** Nursing Department, Faculty of Medicine, Ramathibodi Hospital
Objective : To evaluate the effectiveness of low dose transtympanic gentamicin treatment in Meniere’s disease.
Materials and Methods : Prospective study of 20 disable Meniere’s patients in Ramathibodi Hospital who
received transtympanic gentamicin treatment for Meniere’s disease by fixed dose regimen of 12 injections
during a period of 4 days. The study took place from March 1999 to December 2004. The hearing and
equilibrium guidelines for reporting treatment results in Meniere’s disease of the American Academy of
Otolaryngology and Head & Neck Surgery (1995) were used. The outcomes of treatment were evaluated at the
6th month. The multivariate repeated measures ANOVA was used for statistical comparisons.
Results : During the 5-year period, there were 20 patients, 9 men, and 11 women. The six-month outcomes of
vertigo control, the functional level scale and tinnitus score were significantly improved by the treatment.
Whereas, the mid frequency pure tone threshold average and the speech discrimination score were not signifi-
cantly affected.
Conclusion : Fixed low dose transtympanic gentamicin treatment was found to be an effective treatment option
for patients with disabling or intractable Meniere’s disease, with a low incidence of hearing deterioration.
The use of this method appears to be practical and has been set as the standard protocol replacing the
vestibular surgery in Ramathibodi Hospital.
Keywords : Meniere’s disease, Vertigo, Tinnitus, Pure tone threshold average, Functional level scale, Trans- tympanic gentamicin
