Searching for a cure for Meniere’s disease

Dr Swee T. Aw, Senior Hospital Scientist, Department of Neurology, Royal Prince Alfred Hospital

Dr Swee Aw has been the recipient of Brain Foundation grants for the years 1999, 2000, 2001 and 2002 for different projects in vestibular (ear, balance) research that is unsupported by National Health and Medical Research Council Australia.

About 2500 patients are treated at the Royal Prince Alfred Hospital Balance Disorder Unit every year. The most common balance disorders affecting the inner ear are Meniere’s disease, benign paroxysmal positional vertigo, vestibular neuritis and superior canal dehiscence. These diseases of the inner ear are prevalent and cause visual disturbances, dizziness and imbalance that can result in serious falls especially amongst the elderly.

Dr Aw says “This new Brain Foundation grant has allowed me to initiate a preliminary study into the treatment of Meniere’s disease, an incapacitating condition that is usually characterised by episodic attacks of vertigo or dizziness, fluctuating, progressive, low-frequency hearing loss, tinnitus, and a sensation of “fullness” or pressure in the ear.”

Intratympanic gentamicin (ITG), an antibiotic instilled into the inner ear by injection through the ear drum, is used to treat intractable vertigo attacks, and is a hit-or-miss affair, according to Dr Aw, whose project “Effect of Intratympanic Gentamicin on Vestibular Function in Meniere’s Disease”, aims to assess vestibular function before and after ITG treatment in a group of Meniere’s patients. To date, Dr Aw has collected some preliminary data that has enabled her to set up the parameters that govern the study. She is now testing the patients from the RPA Hearing and Balance Clinic who have volunteered for the project.

Dr Aw’s 2001 grant enabled her to upgrade data acquisition systems to collect data with a much higher precision for the NHMRC Project Grant, “Off-Axis Head Rotation Test of Otolith Function.” The NHMRC grant did not cover equipment funding. The first part of the project has been completed and the manuscript detailing this successful research, titled “Effects of Unilateral Vestibular Deafferentation on the Linear Vestibulo-Ocular Reflex Evoked by Impulsive Eccentric Roll Rotation” has been published in the Journal of Neurophysiology .
(Aw ST, Todd MJ, McGarvie LA, Migliaccio AA, Halmagyi GM. Effects of unilateral vestibular deafferentation on the linear vestibulo-ocular reflex evoked by impulsive eccentric roll rotation. J Neurophysiol 2003; 89:969-978).