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[Intratympanic interval therapy of Menière disease with gentamicin with preserving cochlear function]
Abstract:
For the effective treatment of Menière's disease, gentamicin should be administered at most three times: on days 1, 8 and 15. More than 50% ( n=30) of 57 patients seen between 1997 and 2000 only needed a single dose of gentamicin to obtain a sufficient reaction (single shot-therapy). Vertigo attacks were controlled in 95% of our 57 patients and there were no substantial hearing losses. Four patients lost 15 dB. Tinnitus (46%) and ear pressure (69%) could be controlled or improved. The intratympanic injection-technique (single dose=0.3 ml=12 mg) performed under local anaesthesia is simple and superior to any other procedure. The peak concentration of gentamicin is reached after 2-6 days (average 4.6 days). As soon as signs of inner ear reaction are observed, treatment has been effective and must be stopped immediately to avoid over-intoxication and damage to the cochlea.
Insights
Single-dose gentamicin injections effectively treat Menière
Area of Science:
- Otolaryngology
- Neurology
- Pharmacology
Context:
- Menière's disease is a chronic inner ear disorder.
- Intratympanic gentamicin injections are a common treatment.
- Optimizing gentamicin dosage is crucial for efficacy and safety.
Purpose:
- To evaluate the effectiveness and safety of a single-dose intratympanic gentamicin injection for Menière's disease.
- To determine the optimal timing and dosage for gentamicin treatment.
- To assess the impact of gentamicin on vertigo, tinnitus, and ear pressure.
Summary:
- A single intratympanic gentamicin injection (12 mg) was administered to 57 Menière's disease patients.
- Vertigo attacks were controlled in 95% of patients, with 50% achieving symptom resolution after one dose.
- Tinnitus and ear pressure improved in 46% and 69% of patients, respectively, with minimal hearing loss.
Impact:
- Single-dose intratympanic gentamicin therapy offers a simple, effective, and safe treatment for Menière's disease.
- This approach minimizes the risk of cochlear damage and preserves hearing.
- Early cessation of treatment upon observing inner ear reaction signs is key to preventing over-intoxication.
