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Intratympanic gentamicin therapy for persistent vertigo after endolymphatic sac surgery
1Department of Otolaryngology-Head and Neck Surgery, Loyola University of Chicago, Maywood, Illinois 60153, USA. smarzo@luc.edu
Summary
Intratympanic gentamycin therapy (ITGM) effectively controlled vertigo in 75% of Meniere's disease patients with persistent symptoms after surgery. This treatment may reduce the need for vestibular neurectomy.
Area of Science:
- Otolaryngology
- Neurology
- Vestibular Disorders
Background:
- Meniere's disease can cause debilitating vertigo.
- Endolymphatic sac surgery is a treatment option, but some patients experience persistent or recurrent vertigo.
- Refractory cases require alternative or adjunctive therapies.
Purpose of the Study:
- To assess the efficacy of intratympanic gentamycin therapy (ITGM) for vertigo control.
- To evaluate ITGM in patients with refractory Meniere's disease post-endolymphatic sac surgery.
Main Methods:
- Retrospective review of 491 patients at a university balance clinic.
- Identified 4 patients with Meniere's disease and recurrent vertigo after endolymphatic sac surgery.
- Administered a series of ITGM injections and monitored vertigo control and hearing.
Main Results:
- 75% (3 out of 4) of patients achieved vertigo control with ITGM.
- One patient who did not respond to ITGM successfully underwent vestibular neurectomy.
- No sensorineural hearing loss progression was observed in any patient.
Conclusions:
- Intratympanic gentamycin therapy is a viable option for managing vertigo in select Meniere's disease patients with persistent symptoms after endolymphatic sac surgery.
- ITGM may decrease the necessity for vestibular neurectomy in refractory Meniere's disease cases.