Sudden hearing loss isn’t the only condition that responds to intratympanic (IT) therapy (see "Optimal Usage of Intratympanic Drug Therapy for Sudden Hearing Loss Unclear"). This novel drug delivery method is also effective in easing the vertigo that characterizes Ménière’s disease—a finding that is not surprising given the parallels between the two conditions.
Explore this issue:January 2013
The most fundamental link between Ménière’s and sudden hearing loss is etiology: Both conditions are caused, to varying degrees, by a malfunction of the cochlea and vestibular system; both conditions can fluctuate, making diagnosis and treatment assessments a moving target; and both disorders respond to IT steroid therapy, although for Ménière’s, gentamicin has gained traction due to the aminoglycoside’s ablative effects on vestibular hair cells that are dysfunctional in patients with the balance disorder.
Another parallel between Ménière’s disease and sudden hearing loss is the lack of consensus on the best way to treat the condition. For example, a recent Cochrane review stated that “an effective evidence-based therapy has never been established” for Ménière’s disease (Cochrane Database Syst Rev. 2011;(3):CD008234). But, in reviewing the recent literature on IT gentamicin, the reviewers found two studies that met their main inclusion criteria of being placebo controlled and randomized. Both studies showed a significant reduction in vertigo complaints when compared with placebo, the authors noted. But in one of the trials, 25 percent of patients experienced some hearing loss as a result of gentamicin therapy.