Jahnke K, Arweiler D
Universitäts-Hals-Nasen-Ohrenklinik Essen.
Laryngorhinootologie. 1997 Sep;76(9):519-22. doi: 10.1055/s-2007-997471.
The treatment of severe forms of bilateral Menière's disease remains an especially challenging task. Similar problems also occur in debilitating Menière's disease in the only hearing ear. The intramuscular titration therapy with streptomycin has been the means of choice since 1984 to minimize the risk of total hearing loss in cases of severe bilateral disease.
Since 1989 we have treated six out of 21 cases of bilateral Menière's disease by intravenous application of 2 x 120 mg gentamicin in Ringer's solution for several days. Additionally we reported on two cases in 1988. Only minor amounts of gentamicin were applied to sedate the function of both vestibular organs while avoiding damage to the cochlea.
In two cases hearing approved approximately about 10 dB, in two cases hearing remained stable, and in two cases hearing worsened about 10 dB. Five of six patients showed minor excitability in caloric tests on both sides, they did not complain of vertigo attacks one to five years after therapy.
Given that only very small amounts of gentamicin are applied to sedate the function of the vestibular organ while causing almost no damage to the cochlea, this method seems to be an excellent means for treatment of bilateral Menière's disease. Patients do not experience severe problems with equilibrium afterwards, and the treatment can be repeated as often as necessary.
双侧梅尼埃病严重形式的治疗仍然是一项特别具有挑战性的任务。单耳梅尼埃病导致听力丧失的类似问题也会出现。自1984年以来，链霉素肌肉注射滴定疗法一直是严重双侧梅尼埃病患者将全聋风险降至最低的首选方法。
自1989年以来，我们对21例双侧梅尼埃病患者中的6例进行了治疗，将2×120mg庆大霉素加入林格氏液中静脉注射数天。此外，我们在1988年报告了2例病例。仅使用少量庆大霉素来抑制双侧前庭器官的功能，同时避免对耳蜗造成损害。
2例患者听力提高了约10dB，2例患者听力保持稳定，2例患者听力下降了约10dB。6例患者中有5例在双侧冷热试验中表现出轻微的兴奋，治疗后1至5年他们没有眩晕发作的主诉。
鉴于仅使用极少量庆大霉素来抑制前庭器官功能，同时几乎不会对耳蜗造成损害，这种方法似乎是治疗双侧梅尼埃病的极佳手段。患者之后不会出现严重的平衡问题，并且该治疗可根据需要重复进行。
