Douglas G. Mann, MD, FACS
200A Jones Road, Falmouth, MA 02540 ~ 508.540.0900
Middle Ear Medication for Meniere's and Other Diseases
Instillation of Gentamicin directly into the middle ear has been shown to be of benefit in the treatment of one-sided Meniere’s disease that has not responded to other medical therapy.
Background
Meniere’s disease is a condition whose cause is unknown. The symptoms of Meniere’s disease are brought on when there are wide fluctuations in the function of the balance organ inside the ear. The purpose of the treatment is to reduce the function of the balance organ on one side, thereby reducing the fluctuations.
The effectiveness of Gentamicin, an antibiotic, in this treatment has nothing to do with its antibiotic properties. Gentamicin is ototoxic to the inner ear. It is more toxic to the balance organ than it is to the hearing organ. Thus we are able to use the drug to reduce the function of the balance organ, while usually maintaining the function of the hearing organ.
Method of Treatment
Experiments have shown that best results can be obtained with the lowest chance of hearing loss by giving weekly injections of Gentamicin into the ear.
The first week we will numb the ear drum and make an opening which will allow for the placement of a few drops of the medicine into your middlwe ear. You remain in a relaxed position for 30 minutes to allow the medicine to be absorbed into the inner ear.
A tube is then placed in the opening to keep it open, so that subsequent treatments require only squirting the medicine through to tube into the ear.
Prior to each treatment we do a hearing test to make sure no hearing damage has occurred. After treatment, you are free to leave the office, and should be fine to drive, if you were able to drive to the office in the first place. Two to four weekly treatments usually suffice to control the recurrent attacks. They can be repeated at a later date if symptoms return. Your ear tube will come out of your ear automatically in 6-12 months, or we can remove it for you.
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