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[Intratympanic gentamicin in Menière's disease]
Weining Huang1, Huijie Xu, Bo Gao
1Department of Otorhinolaryngology, Beijing Hospital, Ministry of Health, Beijing, 100730, China.
Objective:
To investigate the effect and toxicity of intratympanic gentamicin injection therapy for intractable vertigo of Menière's disease.
Method:
Thirteen patients diagnosed of unilateral Menière's disease were given gentamicin 0.5 ml (26.7 mg/ml) intratympanically once a week for two weeks. All the patients were followed-up for at least two years. The result was monitored using the criteria set by Chinese Otorhinolaryngological Academy and Editorial Board of Chinese Journal of Otorhinlolaryngology in 1996.
Result:
Complete or substantial vertigo control was achieved in 12 patients (92.3%). Two weeks after treatment, the pure tone (0.5 kHz, 1.0 kHz, 2.0 kHz, 3.0 kHz) average hearing threshold had no significant change. 8.0 kHz hearing threshold increased significantly in 3 patients(23.1%). 18-24 months after treatment, the hearing threshold increased significantly in 9 patients respectively. No patient felt improved in tinnitus.
Conclusion:
Intratympanic gentamicin injection is a simple and cost-effective means for controlling intractable vertigo spelling of Menière's disease, but it also has some toxic effect to hearing.
Insights
Intratympanic gentamicin injections effectively controlled Meniere's disease vertigo in 92.3% of patients. However, this treatment carries a risk of hearing toxicity, particularly at higher frequencies.
Area of Science:
- Otolaryngology
- Nephrology
- Pharmacology
Context:
- Meniere's disease is a chronic inner ear disorder characterized by vertigo, tinnitus, and hearing loss.
- Intractable vertigo in Meniere's disease often requires aggressive treatment options.
- Intratympanic gentamicin injection is a minimally invasive therapeutic approach.
Purpose:
- To evaluate the efficacy and ototoxicity of intratympanic gentamicin injections for managing Meniere's disease.
- To assess the long-term effects of the treatment on vertigo control and hearing thresholds.
Summary:
- Thirteen patients with unilateral Meniere's disease received weekly intratympanic gentamicin injections for two weeks.
- Vertigo was controlled in 12 patients (92.3%) over a two-year follow-up period.
- Significant hearing threshold increases were observed in 23.1% of patients at 8.0 kHz post-treatment and in 69.2% by 18-24 months.
Impact:
- Intratympanic gentamicin offers a simple, cost-effective solution for intractable Meniere's disease vertigo.
- The treatment demonstrates a significant risk of hearing impairment, necessitating careful patient selection and monitoring.
- Further research is needed to optimize gentamicin dosage and administration to minimize ototoxicity while maximizing therapeutic benefits.
