Transtympanic
gentamicin is becoming increasingly popular in the treatment of
Meniere's disease. In this report we examine our experience with the use of microdose
gentamicin via the Round Window Microcatheter for the treatment of
Meniere's disease. Thirty-six patients were treated with
gentamicin administration via the Round Window Microcatheter between July 1997 and August 2000. The patients all underwent 10 days of continuous treatment with a total dose of 2.4-3.75 mg of
gentamicin (10 mg/ml). All patients had extensive pre-, intra-, and post-
therapy auditory and vestibular testing. In this group,
vertigo was eliminated in 89% of the patients, and
tinnitus and pressure were significantly reduced in over 60% of the patients. Only one patient suffered a significant
hearing loss and, most importantly, in all but one patient vestibular function was improved or normalized
after treatment. Round Window Microcatheter-administered microdose
gentamicin is an exciting new treatment for
Meniere's disease. Preliminary results indicate that
vertigo can be controlled without a significant reduction in cochlear or vestibular function in most patients. These results suggest that this
therapy may be acting at a non-hair cell site. Our results are compared to the published literature examining transtympanic injection. In addition, the underlying science supporting this type of treatment is examined.