Intratympanic gentamicin for Ménière's disease or syndrome

Ménière's disease is characterised by three major symptoms: rotational dizziness (vertigo), hearing loss and ringing in the ears (tinnitus), sometimes accompanied by aural fullness. Intratympanic gentamicin is a relatively new therapy with promising results. Gentamicin is an antibiotic which damages the inner ear and the balance organ when it is applied behind the ear drum. This treatment may decrease the spells of vertigo in Ménière's disease. In this review we assess the effectiveness of this kind of treatment for Ménière's disease. Two randomised controlled trials, including a total of 50 patients, were identified which fulfilled the review inclusion criteria. Both of these found a beneficial effect of intratympanic gentamicin therapy for Ménière's disease, although the size of the effect differed between the two trials. Based on these findings, we conclude that intratympanic gentamicin may be an effective treatment for vertigo complaints in Ménière's disease, but it carries a risk of increasing hearing loss. Further research is needed to clarify the effect of intratympanic gentamicin on vertigo in Ménière's disease and the risk of inducing or increasing hearing loss.