Gentamicin tympanoclysis: Effects on the vestibular secretory cells

Results of Electrocochleography in Ménière’s Disease after Successful Vertigo Control by Single Intratympanic Gentamicin Injection

“…In contrast to these hypotheses, some authors have postulated that gentamicin may act by inhibiting endolymph production, thereby diminishing hydrops [Park and Cohen, 1982;Pender, 1985]. Adamonis et al [2000] conducted a similar study to ours, measuring hydrops by noninvasive EcochG before and after ITP-G-treatment.…”

“…On the other hand, it is still unclear if the endolymphatic hydrops decreases when the patients become symptom free. Several authors have suggested that gentamicin acts by inhibiting endolymph production, thereby diminishing hydrops [Park and Cohen, 1982;Pender, 1985].…”

Magnetic Resonance Imaging Fails to Show Evidence of Reduced Endolymphatic Hydrops in Gentamicin Treatment of Ménière’s Disease

“…A possible explanation of the efficacy of low-dosage ITGent treatment is that this drug exerts its action not only by damaging the sensory hair cells but also by downregulating the production of the endolymph, with final reduction of the endolymphatic hydrops (EH) (18,19). In fact, aminoglycosides act on the dark cells and strial marginal cells deputed to endolymph production at significantly lower concentrations compared with those necessary to damage sensory hair cells (18,20,21).…”

Factors Relating to the Vertigo Control and Hearing Changes Following Intratympanic Gentamicin for Intractable Ménière's Disease

“…Although previous studies demonstrated a variety of changes in caloric responses after GM treatments, there are limited data describing the relationships between the vestibular function and treatment outcome, which is a controversial issue; no correlation has been reported (11,12), whereas some other studies revealed correlation between vertigo control and vestibular ablation (13,14). Moreover, it has been hypothesized that intratympanic GM would even induce the recovery of the vestibular function by inhibiting or reducing endolymphatic hydrops via damage to the secretory function of vestibular dark cells (15,16), although a recent report (17) contradicts this theory. However, we suggest that intratympanic GM injections damage vestibular hair cells and thereby block the neurotransmission between hair cells and the vestibular nerve, resulting in a decrease of vertigo spells.…”