The Treatment of Meniere’s Disease by the Intratympanic Therapy

Abstract

Meniere's disease represents one of the most frequent vestibulopathy, with prevalence of 46-200 cases per 100,000, without difference between genders and manifests in fourth decade of life. Features include dizziness/vertigo, hearing loss, tinnitus, and ear fullness. Individuals with Meniere's disease have poor quality of life due to dizziness, regarding physical, functional, and emotional aspects. The therapeutic measures are proposed, depending on the stage of the disease. About 95% of the patients are well controlled with conservative clinical treatment. The remaining 5% have incapacitating symptoms. These patients are candidates for surgical treatments classics, decompression of the endolymphatic sac, vestibular neurectomy, or labyrinthectomy. Intratympanic gentamicin injections emerged as an alternative to surgical treatments, whose risk and benefit ratio has been shown to be much more satisfactory. Aminoglycosides, such as gentamicin have been used since the decade of 1950 for the vestibular chemical ablation in cases of intractable vertigo. The drawback is that gentamicin causes irreversible destruction to cochlear hair cells with hearing loss. The selective vestibulotoxicity in the treatment of Meniere's disease can be used in the treatment of the vertigo promoting a chemical labyrinthectomy.