Intratympanic Gentamicin Injection for Treatment of Vertigo in Intractable Meniere's Disease

Background: Vertigo is being treated by Intratympanic Gentamicin (ITG) among Ménière's Disease (MD) patients, but its effectiveness and safety remain controversial. Objective: To know the optimal dose and duration of intratympanic gentamicin needed to cease vertigo attacks in Ménière’s disease. Patients and Methods: At Oto-Rhino-Laryngology, and Head and Neck Surgery Departments of Zagazig University hospital,eighteen consecutive patients with disabling unilateral Ménière’s disease were included in this randomized controlled trial. The patients were divided randomly into 2 groups; Group A: 9 patients were injected with 20mg/ ml every 3 days for 6 injections, until vertigo completely controlled or presence of complications & Group B: 9 patients were injected with 40mg/ ml every 1 month for 4 injections, until vertigo completely controlled or presence of complications. Results: Twenty mg/ml ITG every 3 days in group A & 40mg/ml ITG every 1month in group B; Both doses can control vertigo, Group A: there was no significant hearing impairment but need repeated rounds of injections, Group B: there was significant hearing impairment and need less rounds of injections. Conclusion: Considering the results of using 20mg/ml ITG every 3 days in group A & 40mg/ml ITG every 1month in group B; Both doses can control vertigo. Group A: there was no significant hearing impairment but need repeated rounds of injections. Group B: there was significant hearing impairment and need less rounds of injections. Using 20mg/ml ITG every 3 days is better and safer than using 40mg/ml ITG every 1 month.