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Treatment of the inner ear through the middle ear: what have we learnt from the gentamicin approach?

We investigated the number of articles listed in MEDLINE every five years from 1976 regarding gentamicin therapy and endolymphatic sac surgery for the treatment of Menière's disease. Gentamicin therapy is now the most used therapeutic modality for the treatment of Menière's disease although the actual number of patients treated is unknown. It should be possible to optimize methods to deliver gentamicin for each patient, including drug amount, administration frequency, and the use of special devices such as microcatheters. Because commercially available gentamicin contains three major components, C1, C2 and C1a, the differences in vestibular and cochlear toxicity among the three components should be investigated to search for more selective vestibulotoxicity.