Intratympanic Low Dose Gentamicin in Intractable Meniere’s Disease- Chemical Labyrinthectomy Revisited

BACKGROUNDMeniere's disease is charecterised by episodic vertigo, fluctuating hearing loss and tinnitus.When medical treatment for Meniere's disease for treatment of vertigo fails i.e. when the vertigo becomes intractable, symptoms are disabling & patients had been unresponsive to medical therapy for at least 1 year, we considered treating them by intratympanic gentamicin injection which is less invasive than surgical labyrinthectomy & therefore more acceptable to some of the patients suffering from intractable vertigo. METHODSA prospective comparative study was conducted in the department of ENT from April 2017 to October 2018 on 32 patients of Meniere's disease having intractable vertigo not responding to conservative treatment.Of these patients, 16 patients were chosen randomly for intratympanic gentamicin injection and the remaining 16 patients acted as control, who were not given intratympanic gentamicin and treated with conservative management. RESULTSIn this study complete vertigo control was found in 87.5% and substantial vertigo control was found in 12.5% of the patients.After treatment with intratympanic gentamicin, 12.5% of the patients showed a further sensorineural hearing loss audiologically. CONCLUSIONSFrom the findings of our study, it can be concluded that low dose intratympanic gentamicin administration is a safe, effective & relatively simple method to control symptoms in patients with intractable Meniere's disease.A larger study is necessary to establish the dosing interval & definite signs of improvement in disease control.