High-dose intratympanic gentamicin instillations for treatment of Meniere's disease: long-term results

Acta Otolaryngol. 2009 Dec;129(12):1420-4. doi: 10.3109/00016480902856612.


Conclusions: Administration of high-dose gentamicin for intractable Meniere's disease appears to be effective in achieving long-term control of vertigo. However, the safety of this route of administration with respect to the patient's hearing has not yet been sufficiently established.

Objectives: The study aimed to analyze the long-term results of patients receiving high-dose intratympanic gentamicin (ITG) instillation for refractory Meniere's disease.

Patients and methods: Fourteen patients with Meniere's disease according to 1995 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guidelines who had failed medical (12 subjects) or surgical (2 subjects) treatment were included. Intratympanic injections of 27 mg/ml gentamicin were performed three times daily for 4 days. Vertigo control, the patients' functional level, and their hearing threshold were all analyzed. Criteria described in 1995 by AAO-HNS were used.

Results: The overall successful vertigo control rate was 92.9% over the 2-year follow-up and 85.7% at long-term follow-up (average 10 years). Hearing level as pure-tone average was worse in four patients (28.5%) after 2 years follow-up and in six patients (42.8%) after long-term follow-up, respectively. Profound sensorineural hearing loss occurred as a result of gentamicin injection in one patient (7%).

MeSH terms

  • Adult
  • Aged
  • Female
  • Follow-Up Studies
  • Gentamicins / administration & dosage
  • Gentamicins / adverse effects*
  • Hearing Loss / chemically induced*
  • Humans
  • Male
  • Meniere Disease / complications
  • Meniere Disease / drug therapy*
  • Middle Aged
  • Protein Synthesis Inhibitors / administration & dosage
  • Protein Synthesis Inhibitors / adverse effects*
  • Vertigo / drug therapy*
  • Vertigo / etiology


  • Gentamicins
  • Protein Synthesis Inhibitors