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Published on: February 27, 2018
Intratympanic gentamicin therapy for intractable Ménière's disease
Lieke De Beer1, Robert Stokroos, Herman Kingma
1Department of Otorhinolaryngology/Head and Neck Surgery, University Hospital Maastricht, Maastricht, The Netherlands.
Conclusions:
Intratympanic gentamicin treatment using a low dose of gentamicin (approximately 21-24 mg per injection) applied at intervals of a minimum of 27 days, has been shown to be a successful treatment of vertigo.
Objectives:
The objective of this analysis was to evaluate the efficacy and side effects of intratympanic injections of gentamicin as treatment of intractable unilateral Ménière's disease.
Patients And Methods:
This was a retrospective study in which 57 patients treated with intratympanic gentamicin for Ménière's disease were analysed. Patients received between 1 and 10 intratympanic injections of gentamicin in an outpatient setting.
Results:
Six months after treatment, overall complete or substantial vertigo control was reported by 80.7% of our patients (VCC class A, 61.4%; class B, 19.3%). Unilateral caloric weakness increased from 50.1% to 79.8% after treatment, and complete caloric areflexia (30 degrees C and 44 degrees C) was induced in 38.6%. In this study hearing worsened (> 10 dB = SNHL) in only 15.8% of our patients (range 10-29 dB) and loss of word recognition (WR) scores worsened (>15%) in 31% of the patients. Only 1 injection was necessary in 49.1% of the patients, the remaining 50.9% needed 2, 3, 4, 6 or 10 injections, always with a time interval of a minimum of 27 days.
