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The antibiotic gentamicin when placed in the middle ear is an effective method of relieving attacks of Ménières disease
in 80% while preserving the hearing in 95%. These results have been obtained using a MicroWick and tube manufactured by Micromedics of Minnesota. The
MicroWick is placed through
a tiny tube in the eardrum and then rests on the round window membrane, the doorway to the inner ear.
THIS NEW TECHNIQUE
developed by Dr. Herbert Silverstein uses dilute gentamicin otic solution (5-10 mg/cc) that the patient places in their ear
three times a day for two to three weeks. This method is similar to treating eye diseases with eye drops. Thus far the
results have excellent in relieving vertigo attacks and preserving the patients hearing. Also, in 60% of patients the pressure
and tinnitus have been reduced.
The minimally invasive office procedure is done using local
anesthesia. The ESC Sharplan CO2 laser is used to create a bloodless opening in the eardrum through which a tiny endoscope
is inserted. Any obstructing membranes near the round window membrane are easily removed with an instrument before the MicroWick is inserted. Next, a tiny tube is inserted
in the tympanostomy opening. Now the round window membrane is clearly seen and the Silverstein Inner Ear MicroWick is inserted. This allows the gentamicin
to reach the round window membrane and diffuse into the inner ear fluids, which will eliminate the dizziness of Ménières disease
in 80%.
The treatment is inexpensive, easy, painless, and well tolerated by the patients. After the
treatment, the tube and the MicroWick are easily removed in the office. The opening in the eardrum rapidly heals. There have been few complications and
the results have been excellent.
The MicroWick technique represents an exciting new method for treating Ménières disease
and allows the delivery of medications, as they are developed, to treat various inner ear diseases such as ringing in the
ears (tinnitus) and certain types of deafness.
Click here for research paper summaries:
1) Self-treatment of inner ear disease using otic medication delivered by the
Silverstein MicroWick
2)
Use of a new device, the MicroWick to deliver medication to the inner ear
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