1. Community
  2. Ears, nose, throat and mouth
  3. Meniere's Disease

Dexamethasone vs Gentamicin injections for MD

Posted , 6 users are following.

BrianBelleair
BrianBelleair

I have had Meniere's Disease for about 5 years now and the episodes have started again in early April, nearly daily.  I take the meclizine to counter the attack and my ENT put me on Diamox (acetazolamide) daily. At first the Diamox seemed to help, but now 4 weeks later it does not seem to work as well.  I few episodes a few times a week.  I've been on a low sodium diet for this entire 6 weeks or so but I guess it helps, I'm not totally sure yet. I never go anywhere with out my chewable meclizine tabs as these seem to work after about 30-60 minutes.

I'm really getting frustrated with not being able to do "normal" things without the anxiety of an episode happening that puts me down for hours.

I've got 70% hearing loss in my right ear now and would like to consider the steriod or gentamicin injections.  I read that ENT's are hesitant to give the steroids as it is only a temporary "fix" and that many seem to recommend the gentamicin instead.  

I'm not that concerned about further hearing loss in my ear as at 70% I can't hear anything from that ear anyway with 70% loss.

Can anyone recommend an ENT Meniere's specialist in the Tampa Bay area?  The ENT I'm seeing seems to take my situation as I'm doing something wrong by not eating right etc.  But I read quite a few people seem to be basically totally symptom free after steroid or gentamicin injections......I would like to see an ENT that has experience with both and perhaps try the steroid first as it seems not quite as permanent as the gentamicin....can someone please shed some legitimate information about the two treatments and hopefully suggest an ENT in Pinellas or Hillsborough county?

 

0 likes, 24 replies

24 Replies

Prev
  • BrianBelleair
    BrianBelleair

    Posted

    I had the Gentamicin injection performed on my right ear on Thursday, and right away it seems to have cleared up the foggy/and ear fullness.  The tinnitus has seemed to have changed (not gone away but seems perhaps less) also. At this point i'm not sure of the long term but as of now I have not had any recurring attacks in a couple of weeks (no to low sodium/no caffeine etc). I'm still on a diuretic; Triamterene-hydrochlorothiazide (37.5-25mg) daily also. I'm feeling back to normal, almost considering the constant urination. The current plan is to check my hearing in another week and if there is no degradation then there will be an additional injection.  There seems to be no loss, that I can tell, but then I do have 70% loss in that ear already. The best thing so far seems to be the ear no longer has that constant total fullness feeling. Thanks everyone for your support. Hopefully I turned the corner on the vertigo attacks.

    • tanney
      tanney BrianBelleair

      Posted

      wonderful news, Brian.  We wish you the very best.  For the benefit of those folks on this forum still thinking about having the gentamicin injection procedure, Brian, please continue to update us on your status.  It will be great information in helping others to arrive at a decision.
  • dominic77963
    dominic77963 BrianBelleair

    Posted

    Hi Brian, I was diagnosed with Ménière's 14 months ago,so far I had 4 episodes of vertigo last episode 5/3 was a drop attack. Since I have been getting them every 3 or 4 months I can accept it but my main problem is the tinnitus.

    You had this for 35 years how long did it take you to habituate?

    Dom

    • tanney
      tanney dominic77963

      Posted

      Hi Dominic.  Your questions was probably meant for me.....Habituating to tinnitus is a slow process. In my case it took several years.   If tinnitus level (degree of loudness) does not change over time then it can occur more rapiidly. This past August I developed MD in second ear (bilateral MD) and tinnitus is now louder in original MD ear along with new MD ear.  I've also developed pulsatile tinnitus in original MD ear.  I'm now constantly aware of both the pulsatile and continuous tinnitus.  I'm hoping the Betahistine regimine quiets both of these...but it has not as yet. 

    • dominic77963
      dominic77963 tanney

      Posted

      thank you for your response, my tinnitus is so loud that i am having difficulty thinking

      ​i am hoping to habituate soon

      dom

  • JMJ
    JMJ BrianBelleair

    Posted

    Hi Brian,

    I'm sorry that I'm so late to this post.  I just want to say that I'm a huge proponent of steroid injections.  While it's not a "quick fix", I've found that it's been incredibly effective in eliminating the symptoms of MD, and with my latest round, I'm actually experiencing decreased tinnitus, which has increased my hearing ability quite a bit. 

    I'm at peace with perhaps needing a steroid injection every few months for the rest of my life.  For me, it's  a small price to pay for such enormous relief.  I'm very grateful to have landed with an otolaryngologist who believes in going the steroid route first. If someone is getting absolutely no relief after a few months, then he will administer the Gentamycin. His steroid regimen is 10mg Dexamethasone every 4 weeks until complete remission, and then gradual widening of the intervals between injections.

    I hope you'll let us know what you decided, and how you're doing!

    Wishing you all the best,

    J-

     

    • BrianBelleair
      BrianBelleair JMJ

      Posted

      JMJ, thanks the experience you've explained, I have 70% hearing loss in the right ear, I cannot really hear anything from that ear as far as i can really distinguish in a normal day with loud tinnitus.  My ENT suggested I use the Gentamycin as he has indicated the steroid is a temporary fix.  Given this much hearing loss and hopefully a permanent solution I have had 2 injections of the gentamycin now in my right ear in the last 3 weeks (2 weeks apart). I have not had any further attacks and cannot tell if I've had further hearing loss in the ear.  I'm due for a follow-up next week and another hearing test.  So far so good.  I've had no real reduction in tinnitus but as mentioned no attacks....I remain on the diuretic for now, but hope to slowly come off of this also, maintaining my low salt diet (I've lost 30lbs also). I've been able to start jogging a bit also, so my overall health has inproved.  I just hope the attacks are now a thing of the past.

      Brian

    • JMJ
      JMJ BrianBelleair

      Posted

      Brian,

      I'm happy to hear that you're doing so well.  You never know what your answer will be until you give it a try.   And each case is so different, you have to follow your own intuition as well as trust your physician to lead you down the right path.   Sounds like you did both, and it's working out for you!  I hope, along with you, that your attacks are now a thing of the past.  Congrats on losing the 30 pounds and getting more active!  That's wonderful!  The Gentamycin mustn't have had an effect on your balance....that's great!

      Thanks so much for the update!  I was hoping that you would share your experience!  Wishing you all the very best!

      J-

    • BrianBelleair
      BrianBelleair JMJ

      Posted

      I have not noticed any effect on my balance whatsoever, and I’ve been an active person, working on my car hobby and lots of boat and yard work. Thanks for your words of support and I hope others that read this and are suffering that there may be some treatments and relief, I definitely remember the worst days and weeks I was suffering without seeing an end.  I continued to work with the ENT to get relief and hopefully agree on long term treatment.  The gentamycin has worked for me for now, I’ll continue to hopefully understand if this can be a long lasting…..we’ll see.  My wife has been such a strong supporter, I can’t imagine going through this on my own.   Best of luck to others, don’t give up!

      Brian

      (Clearwater, Florida area)

Back to top
Prev

Report or request deletion

Thanks for your help!

We want the community to be a useful resource for our users but it is important to remember that the community are not moderated or reviewed by doctors and so you should not rely on opinions or advice given by other users in respect of any healthcare matters. Always speak to your doctor before acting and in cases of emergency seek appropriate medical assistance immediately. Use of the community is subject to our Terms of Use and Privacy Policy and steps will be taken to remove posts identified as being in breach of those terms.