Intratympanic gentamicin treatment after endolymphatic sac surgery

Area of Science:

• Otolaryngology
• Neuroscience

Background:

• Ménière's disease can cause recurrent vertigo, sometimes persisting after endolymphatic sac surgery (saccotomy).
• Established treatments for post-saccotomy vertigo include revision surgery or more invasive procedures.
• Intratympanic gentamicin is proposed as an alternative treatment for refractory vertigo post-saccotomy.

Purpose of the Study:

• To evaluate the efficacy of intratympanic gentamicin in controlling vertigo.
• To assess hearing preservation in patients with Ménière's disease experiencing vertigo post-saccotomy.
• To present gentamicin as a viable alternative treatment option.

Main Methods:

• Five patients with definite Ménière's disease and post-saccotomy vertigo received weekly intratympanic gentamicin injections (12 mg).
• Vertigo control and hearing preservation were assessed over a 26-59 month follow-up period.
• Audiometry and patient history were used for evaluation, with statistical comparison of hearing thresholds.

Main Results:

• Complete vertigo control (Class A) was achieved in all patients.
• Hearing preservation was maintained across tested frequencies (0.5, 1, 2, and 3 kHz).
• The treatment was effective in managing incapacitating vertigo episodes.

Conclusions:

• Weekly intratympanic gentamicin injections offer an effective treatment for vertigo in Ménière's disease patients post-saccotomy.
• This treatment approach successfully controls vertigo while preserving hearing.
• It represents a valuable alternative to established surgical interventions.