The Impact Of Intratympanic Gentamicin On Endolymphatic Hydrops, Vestibular Function And Clinical Efficacy In Meniere's Disease

XXIII. World Congress of Otorhinolaryngology Head and Neck Surgery, İstanbul, Türkiye, 9 - 13 Eylül 2026, ss.292-293, (Özet Bildiri)

BACKGROUND & AIM

Patients with Meniere's disease whose symptoms remain refractory despite medical management are candidates for

intratympanic gentamicin (ITG). Endolymphatic hydrops is widely recognized as the histopathological hallmark of the disease,

driven by endolymph secretion from the stria vascularis and dark cells. Recently, specific magnetic resonance imaging (MRI)

grading systems have emerged to evaluate hydrops severity. However, the exact effect of ITG on hydrops level and conversely,

the impact of baseline hydrops on treatment outcomes remains unclear. This study aims to investigate these radiological and

clinical relationships.

Oral Presentations | 292MATERIAL & METHODS

This retrospective study included 21 patients with unilateral Meniere's disease undergoing ITG therapy. To evaluate

radiological evolution, patients underwent pre- and post-intervention temporal bone MRI(1.5 T) using a Meniere-specific

protocol. Cochlear and vestibular hydrops severity was independently graded by a neuroradiologist. Clinically, patients were

assessed pre- and post-interventionally. Vestibular function was quantified using the video head impulse test (vHIT), hearing

status via bone conduction pure-tone audiometry (PTA) thresholds, and quality of life using the Dizziness Handicap Inventory

(DHI).

RESULTS

Following ITG injection, lateral semicircular canal (LSC) gains and DHI scores significantly decreased (p=0.029, p=0.007).

Changes in bone PTA thresholds and anterior/posterior canal gains were not statistically significant. Radiologically, cochlear

hydrops regressed in 4 patients and progressed in 3, while vestibular hydrops regressed in 4 and progressed in 2; these overall

changes lacked statistical significance. However, changes in cochlear hydrops severity significantly correlated with changes in

bone PTA thresholds (p=0.013, r=0.530). DHI improvements showed no correlation with hydrops changes. Furthermore,

baseline cochlear and vestibular hydrops grades did not predict the extent of DHI improvement, vHIT alterations, or bone PTA

shifts.

CONCLUSIONS

ITG effectively alleviates vertigo symptoms and reduces LSC gain without causing significant hearing loss or consistent

radiological changes in endolymphatic hydrops. Furthermore, baseline MRI hydrops grading is not a reliable predictor of

clinical or functional responses to ITG, indicating that treatment efficacy is largely independent of initial radiological severity.

KEYWORDS

Meniere disease, Intratympanic gentamicin, endolymphatic hydrops, Magnetic Resonance Imaging,Vertigo