Nausea, vertigo, tinnitus, and hearing loss—the symptoms of Ménière’s disease can really throw one off-course.

In the past, treatment of extreme cases of Ménière’s disease included severing the vestibular nerve or surgical removal of the entire vestibular organ.  Now, a less invasive treatment can be utilized, with an antibiotic called gentamicin, Karl Landsteiner University of Health Sciences announced on its website. By placing the antibiotic—an known ototoxin—into the middle ear, a side effect of the drug can be used therapeutically, says the university: Gentamicin is said to reduce the excitability of the vestibular cells in a targeted manner. Researchers have now reexamined 32 Austrian treatment cases between 2012 and 2015 and evaluated the results.

“Our evaluations confirm the effectiveness of this simple treatment method,” explained Dr Béla Büki, head of the outpatient department for hearing and balance disorders at the Krems University Hospital of Krems. “In over a third of the cases, only a single injection was necessary to achieve a noticeable and lasting relief of the symptoms.”

The results from Austria thus confirmed other studies in which this treatment method was used therapeutically, according to the school’s announcement.  However, in some cases, the initial effect of the treatment subsided after a few months and further injections were necessary to achieve a more lasting effect.

Dr Heinz Jünger was particularly interested in whether details of the initial treatment success could be used to predict the long-term course of symptom relief. The effect of the treatment on the individual parts of the equilibrium organ—including the labyrinth, which consists of three bony archways arranged in a spatially complex distribution to each other—was analyzed.

“In fact, our evaluation showed that the effect of the antibiotic in one channel of the labyrinth correlated strongly with its effect in the other two,” Büki said.

The research team also evaluated data from a measurement method designed to detect human reflex, known as the vestibulo-ocular reflex (VOR). This reflex compensates for rapid head movements with opposite eye movements, stabilizing images on the retinas and allowing people to focus on images even when the head is moving. In disorders of the vestibular system, this reflex is reduced to varying degrees and can be used as a measure of the degree of the disease or the success of treatment. By evaluating these data, it was found that the initial success of the treatment did not indicate whether another injection of the antibiotic would be necessary in a few months, and researchers are utilizing a “wait-and-see” approach.

The detailed analysis of a very simple form of treatment for a rare and complex disease is a notable example of research at KL Krems, which focuses on niche fields in areas relevant to health policy.

Source: Karl Landsteiner University of Health Sciences