Intratympanic gentamicin for the treatment of Meniere's Disease and other forms of peripheral vertigo

Few therapies for Meniere's disease or other forms of peripheral vertigo have undergone such dramatic reappraisals as has the use of intratympanic aminoglycosides. Soon after its introduction in 1957, the therapy fell into disfavor because of the high rate of sensorineural hearing loss encountered in the initial studies. Reductions in the frequency of intratympanic administration have improved the preservation of hearing without compromising vertigo control. This article reviews the history of intratympanic aminoglycoside treatment since the 1950s, some of the important basic science findings relevant to the delivery and effects of intratympanic gentamicin, and indications for treatment and current treatment protocols and outcomes.