Transtympanic (TTG) or Intratympanic (ITT) Gentamicin Treatment

This procedure is used in treating severe cases of episodic vertigo, such as those experienced with Meniere’s disease. It is considered the treatment of last resort.

A local anesthetic is used to numb the eardrum; then a drop of phenol on the eardrum or "Emla" cream, a topical anesthetic, is injected. Gentamicin (a medication that purposefully damages the inner ear to stop dizzy spells) is injected through the eardrum using a narrow needle. The drug is left in the middle ear for 30 minutes and is then allowed to drain out. General protocol with this treatment calls for just one or two injections in total spaced a month apart.

Disability is lessened in patients with Meniere’s after TTG treatment. Dizziness may return in a year, requiring another series of injections. The long-term effect on hearing is unclear; it may accelerate hearing loss. One major advantage with TTG is its low cost, compared to alternative treatments (vestibular nerve section or labyrinthectomy) and also low risk because using general anesthesia is not required.