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Intratympanic gentamicin: a 1-day protocol treatment for unilateral Meniere's disease
Alessandro De Stefano1, Francesco Dispenza, Giuseppe De Donato
1Clinica ORL, Università G. d'Annunzio, Chieti-Pescara, Italy.
Purpose:
The objective of this study was to assess the usefulness of low-dose intratympanic gentamicin administration in patients with Meniere's disease (MD).
Materials And Methods:
We carried out a retrospective review of the charts of 55 patients with definite MD in accordance with the AAO-HNS (American Academy of Otolaryngology-Head and Neck Surgery) Diagnostic Scale who were treated at Gruppo Otologico (Piacenza, Rome, Italy). The treatment protocol consisted of 3 intratympanic injections of gentamicin at a 12-hour interval between each administration.
Results:
Results were resumed in accordance with AAO-HNS criteria and showed complete control of vertigo spells in 60% (class A), good control in 16% (class B), moderate control in 4% (class C), poor control in 16% (class D), and no control in 4% (class E) of the patients. Audiological assessment showed unchanged thresholds in 61%, improvement in 22%, and worsening in 17% of the cases.
Conclusion:
Administration of gentamicin is a good alternative to medical and surgical procedures in the treatment of intractable MD. One-day treatment allows for adequate control of vertigo attacks without compromising hearing and quality of life and with reduced costs.
Insights
Low-dose intratympanic gentamicin effectively controls Meniere
Area of Science:
- Otolaryngology
- Neurotology
Background:
- Meniere's disease (MD) presents significant challenges in vertigo management.
- Intratympanic gentamicin is an established treatment, but optimal dosing requires investigation.
Purpose of the Study:
- To evaluate the efficacy of low-dose, short-duration intratympanic gentamicin for Meniere's disease.
- To assess the impact on vertigo control and hearing function.
Main Methods:
- Retrospective chart review of 55 patients with definite Meniere's disease.
- Treatment involved 3 intratympanic gentamicin injections over 12 hours.
- Outcomes assessed using American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) criteria.
Main Results:
- Complete vertigo control (Class A) achieved in 60% of patients.
- Good to moderate control (Class B/C) in 16% and 4% respectively.
- Audiological thresholds remained unchanged in 61% and improved in 22%.
Conclusions:
- Low-dose intratympanic gentamicin offers a viable alternative for intractable Meniere's disease.
- This one-day protocol effectively manages vertigo without significant hearing compromise.
- The treatment presents a cost-effective option with improved quality of life.
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