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Treatment of Menière's disease with topical gentamicin: a preliminary report
J M Nedzelski1, G E Bryce, A G Pfleiderer
1Department of Otolaryngology, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada.
Abstract:
We evaluated the hypothesis that topical intratympanic gentamicin can relieve the vertigo of disabling Menière's disease, reduce or ablate vestibular caloric excitability, and preserve hearing. Between July 1988 and June 1989, 33 patients were treated in the Dizziness Unit at the Sunnybrook Health Sciences Centre in a prospective controlled trial. This preliminary report presents the results of 29 patients with follow-up averaging 8.3 months and ranging from one to 18 months. All patients had either complete (86.2%) or substantial (13.8%) control of vertigo. Caloric excitability was ablated in 63% and reduced in 25.9% of subjects. Hearing was improved in 35.7%, unchanged in 39.3%, and worse in 25.0% of patients. In this preliminary review, the overall success rate for this treatment is 89.7% if control of vertigo and improvement in disability level are the criteria examined.
Insights
Topical intratympanic gentamicin effectively controls vertigo in Meniere
Area of Science:
- Otolaryngology
- Neurology
Background:
- Meniere's disease causes disabling vertigo.
- Vestibular function is often impaired.
Purpose of the Study:
- Evaluate topical intratympanic gentamicin for Meniere's disease.
- Assess vertigo control, vestibular excitability, and hearing preservation.
Main Methods:
- Prospective controlled trial.
- 33 patients treated with topical intratympanic gentamicin.
- 29 patients analyzed with 8.3-month average follow-up.
Main Results:
- 86.2% complete vertigo control, 13.8% substantial control.
- 63% caloric excitability ablation, 25.9% reduction.
- 35.7% hearing improvement, 39.3% unchanged, 25.0% worse.
Conclusions:
- Topical intratympanic gentamicin offers significant vertigo relief.
- Treatment can reduce or ablate vestibular function.
- Hearing outcomes are variable but overall success is high.
