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Low dose transtympanic gentamicin treatment for intractable Meniere's disease: a prospective study
Lalida Kasemsuwan1, Chanchai Jariengprasert, Suwimol Ruencharopen
1Otolaryngology Department, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand.
Objective:
To evaluate the effectiveness of low dose transtympanic gentamicin treatment in Meniere's disease.
Material And Method:
Prospective study of 20 disable Meniere's patients in Ramathibodi Hospital who received transtympanic gentamicin treatment for Meniere's disease by fixed dose regimen of 12 injections during a period of 4 days. The study took place from March 1999 to December 2004. The hearing and equilibrium guidelines for reporting treatment results in Meniere's disease of the American Academy of Otolaryngology and Head & Neck Surgery (1995) were used. The outcomes of treatment were evaluated at the 6th month. The multivariate repeated measures ANOVA was used for statistical comparisons.
Results:
During the 5-year period, there were 20 patients, 9 men, and 11 women. The six-month outcomes of vertigo control, the functional level scale and tinnitus score were significantly improved by the treatment. Whereas, the mid frequency pure tone threshold average and the speech discrimination score were not significantly affected.
Conclusion:
Fixed low dose transtympanic gentamicin treatment was found to be an effective treatment option for patients with disabling or intractable Meniere's disease, with a low incidence of hearing deterioration. The use of this method appears to be practical and has been set as the standard protocol replacing the vestibular surgery in Ramathibodi Hospital.
