Follow-up assessment of intratympanic gentamicin therapy and saccotomia in Meniere's disease

Background: The intratympanic application of ototoxic antibiotics and saccotomia have been well documented in severe cases of one-sided Meniere's disease for 30 years now. Both treatment methods are still subject to controversial discussion. Patients and material: This study includes 8 patients suffering from persistent one-sided Meniere's disease after treatment with gentamicin application and additional saccotomia (n = 2). We performed follow-up visits including the assessment of hearing ability, vestibular function and cranial MRI, 2-10 years after onset of treatment. Results: After therapeutic interventions 7 patients reported to be healed of their symptom vertigo. In 4 patients the gentamicin-treated vestibular organ did not respond to thermic stimulus at the time of follow-up examination. Auditory threshold shift was observed in 3 patients (1 permanent, 2 temporary), whereas hearing threshold improved in 2 patients. Tinnitus was attenuated in 3 patients, while I patient suffered from posttherapeutic onset of tinnitus. Morphological and structural changes due to Meniere's disease and treatment procedures were ruled out by cranial MRI. Conclusion: The intratympanic application of ototoxic medication is a safe and effective treatment method in severe cases of Meniere's disease. Saccotomia should be considered as therapeutic regimen for persistent symptoms after repeated application of gentamicin.