{"id":13703,"date":"2025-06-19T13:51:39","date_gmt":"2025-06-19T11:51:39","guid":{"rendered":"https:\/\/ivrt.de\/?p=13703"},"modified":"2026-02-06T16:57:38","modified_gmt":"2026-02-06T15:57:38","slug":"transtympanales-gentamicin-bei-morbus-meniere-wirksamkeit-mit-vorbehalt","status":"publish","type":"post","link":"https:\/\/ivrt.de\/en\/studien-evidenz\/transtympanales-gentamicin-bei-morbus-meniere-wirksamkeit-mit-vorbehalt\/","title":{"rendered":"Transtympanic gentamicin for M\u00e9ni\u00e8re\u2019s disease \u2013 effectiveness with caution"},"content":{"rendered":"<p><strong>For Healthcare Professionals:<\/strong><\/p>\n\n\n\n<p><strong>Background:<\/strong><br><a href=\"https:\/\/ivrt.de\/en\/patientenedukation\/morbus-meniere\/\" data-type=\"post\" data-id=\"7403\">Meniere's disease<\/a> is a chronic progressive inner ear disorder characterized by recurrent vertigo attacks, tinnitus, aural fullness, and fluctuating sensorineural hearing loss. For patients with therapy-refractory courses, transtympanic administration of gentamicin is considered as an ablative vestibulotoxic intervention.<\/p>\n\n\n\n<p><strong>Objective of the review:<\/strong><br>A systematic review with meta-analysis evaluated the <strong>efficacy and safety of transtympanic gentamicin injections<\/strong> in M\u00e9ni\u00e8re\u2019s disease, based exclusively on randomized controlled trials (RCTs). <\/p>\n\n\n\n<p>\ud83d\udd17 <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40424142\/\"><strong>Original study<\/strong><\/a><strong><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40421807\/\">u<\/a><\/strong><a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40424142\/\"><strong>on PubMed<\/strong><\/a><\/p>\n\n\n\n<p><strong>Study design &amp; methods<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Data base:<\/strong> 3 RCTs comparing gentamicin with placebo or no treatment<\/li>\n\n\n\n<li><strong>Assessment system:<\/strong> GRADE for risk of bias and certainty of evidence<\/li>\n\n\n\n<li><strong>Primary outcomes:<\/strong>\n<ul class=\"wp-block-list\">\n<li>Frequency and severity of vertigo attacks<\/li>\n\n\n\n<li>Quality of life<\/li>\n\n\n\n<li>Incidence of serious adverse events<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n\n\n\n<p><strong>Key results<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Dizziness attacks<\/strong><br>All three RCTs showed significant reduction in frequency and intensity with gentamicin compared with control.<\/li>\n\n\n\n<li><strong>Quality of life:<\/strong><br>Positive trends, but inconsistently assessed and difficult to compare.<\/li>\n\n\n\n<li><strong>Side effects:<\/strong><br>Serious side effects were rare, but systematic assessment and long-term data were lacking.<\/li>\n\n\n\n<li><strong>Evidence quality:<\/strong><br>Despite positive effects, overall certainty of evidence was <strong>rated very low<\/strong> , mainly due to small sample sizes and methodological inconsistencies.<\/li>\n<\/ul>\n\n\n\n<p><strong>Conclusion for Practice<\/strong><\/p>\n\n\n\n<p>Transtympanic gentamicin appears to be a promising option for vertigo reduction in therapy-resistant M\u00e9ni\u00e8re\u2019s disease. However:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>The <strong>evidence base remains weak<\/strong> \u2014 no robust foundation for broad application.<\/li>\n\n\n\n<li>There is a clear <strong>need<\/strong> for larger, high-quality studies with standardized protocols, especially regarding dosing, frequency, and long-term safety.<\/li>\n<\/ul>\n\n\n\n<p>\ud83d\udc49 <strong>&nbsp;Want to deepen your knowledge of M\u00e9ni\u00e8re\u2019s disease?<\/strong><br>Current further education opportunities can be found in the <strong><a href=\"https:\/\/ivrt.de\/en\/fuer-medizinisches-fachpersonal\/fortbildungssuche\/\" data-type=\"link\" data-id=\"https:\/\/ivrt.de\/fuer-medizinisches-fachpersonal\/fortbildungssuche\/\">IVRT Course search<\/a>.<\/strong><\/p>\n\n\n\n<p><\/p>\n\n\n\n<hr class=\"wp-block-separator has-alpha-channel-opacity\"\/>\n\n\n\n<p><\/p>\n\n\n\n<p><strong>For Patients \u2013 Easy to Understand<\/strong><\/p>\n\n\n\n<p><strong>M\u00e9ni\u00e8re\u2019s disease: Can ear injections stop vertigo?<\/strong><\/p>\n\n\n\n<p><strong>What is M\u00e9ni\u00e8re\u2019s disease?<\/strong><br>An inner ear condition that causes sudden vertigo attacks, ringing in the ear (tinnitus), pressure in the ear, and hearing loss. Symptoms often occur in episodes and can be very distressing.<\/p>\n\n\n\n<p>One possible treatment: Gentamicin injections into the ear<\/p>\n\n\n\n<p>\u2192 Gentamicin is an antibiotic, but here it is used not for its antibacterial effect. Instead, it is injected through the eardrum directly into the inner ear.<\/p>\n\n\n\n<p>\u2192 It targets specific sensory cells in the balance organ. Normally, these cells detect motion. In <a href=\"https:\/\/ivrt.de\/en\/patientenedukation\/morbus-meniere\/\" data-type=\"post\" data-id=\"7403\">Meniere's disease <\/a>, they can send false signals, causing severe vertigo.<\/p>\n\n\n\n<p>\u2192  By <a href=\"https:\/\/ivrt.de\/en\/patientenedukation\/vestibulotoxizitaet\/\" data-type=\"link\" data-id=\"https:\/\/ivrt.de\/patientenedukation\/vestibulotoxizitaet\/\">partially disabling these cells, gentamicin<\/a>can reduce or even stop vertigo attacks.<\/p>\n\n\n\n<p><strong>What does the new review say?<\/strong><\/p>\n\n\n\n<p>A Danish research team analyzed three high-quality studies (published 2025).<\/p>\n\n\n\n<p>\ud83d\udcc4 <a href=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40421807\/\" data-type=\"link\" data-id=\"https:\/\/pubmed.ncbi.nlm.nih.gov\/40421807\/\">Original study<\/a><\/p>\n\n\n\n<p><strong>Main findings:<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><strong>Less dizziness:<\/strong><br>Many treated patients had fewer and milder attacks.<\/li>\n\n\n\n<li><strong>Better quality of life:<\/strong><br>Some reported meaningful improvement in daily life.<\/li>\n\n\n\n<li><strong>But:<\/strong> The studies were small, and the evidence is not yet strong enough for clear recommendations.<\/li>\n<\/ul>\n\n\n\n<p><strong>Is this suitable for me?<\/strong><\/p>\n\n\n\n<p>This treatment may be an option if other measures fail. Still, keep in mind:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>It can in rare cases sometimes affect hearing.<\/li>\n\n\n\n<li>The effect is not the same for everyone.<\/li>\n\n\n\n<li>Careful medical evaluation is essential.<\/li>\n<\/ul>\n\n\n\n<p><strong>Conclusion<\/strong><\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>Gentamicin injections may offer relief for patients with severe vertigo.<\/li>\n\n\n\n<li>The scientific evidence is promising, but still too limited for general use.<\/li>\n\n\n\n<li>Always seek thorough medical advice before deciding.<\/li>\n<\/ul>\n\n\n\n<p>\ud83d\udc69\u200d\u2695\ufe0f <strong>You are considering a gentamicin therapy?<\/strong><br>Gentamicin can also <strong>weaken the balance organ<\/strong> - this is called a <strong>vestibular hypofunction<\/strong>.<\/p>\n\n\n\n<p>This weakening occurs <a href=\"https:\/\/ivrt.de\/en\/patientenedukation\/vestibulotoxizitaet\/\" data-type=\"post\" data-id=\"7355\">because sensory cells in the inner ear are partially deactivated by the medication<\/a>. In everyday life, this can lead to new challenges\u2014for example, when walking in the dark, on uneven ground, or during rapid head movements.<\/p>\n\n\n\n<p>\u27a1\ufe0f The good news: These problems can be effectively improved with <a href=\"https:\/\/ivrt.de\/en\/patientenedukation\/vestibulaere-rehabilitationstherapie-und-gleichgewichtstraining\/\" data-type=\"post\" data-id=\"8932\">vestibular rehabilitation therapy<\/a><strong> verbessern<\/strong>.<\/p>\n\n\n\n<p>\ud83c\udfaf <strong>Specially trained IVRT\u00ae dizziness and vestibular therapists<\/strong> can be found via our <strong><a href=\"https:\/\/ivrt.de\/en\/fuer-betroffene\/therapeutensuche\/\" data-type=\"page\" data-id=\"101\">IVRT therapist search<\/a><\/strong><\/p>\n\n\n\n<p><a id=\"_msocom_1\"><\/a><\/p>\n\n\n\n<p><\/p>\n\n\n\n<p><\/p>","protected":false},"excerpt":{"rendered":"<p>F\u00fcr Fachpersonal: Hintergrund:Morbus Meni\u00e8re ist eine chronisch-progrediente Erkrankung des Innenohrs, die mit wiederkehrendem Drehschwindel, Tinnitus, auralem Druckgef\u00fchl und fluktuierendem sensorineuralem H\u00f6rverlust einhergeht. F\u00fcr Patient:innen mit therapierefrakt\u00e4ren Verl\u00e4ufen wird die transtympanale Gabe von Gentamicin als ablative vestibulotoxische Intervention in Erw\u00e4gung gezogen. Ziel der Analyse:Eine systematische \u00dcbersichtsarbeit mit Metaanalyse untersuchte die Wirksamkeit und Sicherheit transtympanaler Gentamicin-Injektionen bei [&hellip;]<\/p>\n","protected":false},"author":11,"featured_media":13709,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_surecart_dashboard_logo_width":"180px","_surecart_dashboard_show_logo":true,"_surecart_dashboard_navigation_orders":true,"_surecart_dashboard_navigation_invoices":true,"_surecart_dashboard_navigation_subscriptions":true,"_surecart_dashboard_navigation_downloads":true,"_surecart_dashboard_navigation_billing":true,"_surecart_dashboard_navigation_account":true,"_jf_save_progress":"","iawp_total_views":421,"footnotes":""},"categories":[215],"tags":[],"class_list":["post-13703","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-studien-evidenz"],"_links":{"self":[{"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts\/13703","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/users\/11"}],"replies":[{"embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/comments?post=13703"}],"version-history":[{"count":1,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts\/13703\/revisions"}],"predecessor-version":[{"id":17486,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/posts\/13703\/revisions\/17486"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/media\/13709"}],"wp:attachment":[{"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/media?parent=13703"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/categories?post=13703"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/ivrt.de\/en\/wp-json\/wp\/v2\/tags?post=13703"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}