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Chemical ablation is sometimes used to reduce severe symptoms of
vertigo from Ménière's disease. The goal of treatment for Ménière's disease is to eliminate symptoms while keeping as much hearing in the ear as possible.
During chemical ablation, an antibiotic—usually
gentamicin but sometimes streptomycin—is injected with a small, thin
needle into the inner ear to damage the part of the ear that controls balance.
You are first given a local anesthetic in your ear so the injection isn't
painful. The antibiotic is left in your middle ear for about 30 minutes and
then allowed to drain out.
Typically, a single injection is given once a week over a course of 4
weeks. It may take 1 to 2 weeks for symptoms of vertigo to totally subside.
Treatments stop after you no longer respond to warm or cool water or air as it
is gently pulsed into each ear canal. This means that the cells in the
balance center of your inner ear have been destroyed.
Chemical ablation is usually reserved for people who haven't been
able to control symptoms of severe vertigo with other treatments. Ablation with gentamicin will cause some hearing loss in about 1 out of 4 people who have it.1 The possibility of losing your hearing in one ear is a major consideration when deciding whether to have chemical ablation to treat Ménière's disease. In some cases, the disease may have already damaged your hearing, which makes the risk of being deaf in that ear less of a consideration.
Storper IS (2010). Ménière syndrome. In LP Rowland, TA Pedley, eds., Merritt's Neurology, 12th ed., pp. 963–966. Philadelphia: Lippincott Williams and Wilkins.
April 12, 2012
Anne C. Poinier, MD - Internal Medicine & Barrie J. Hurwitz, MD - Neurology
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