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Hearing results following intratympanic gentamicin perfusion for Ménière's disease
E Kyrodimos1, I Aidonis, A Sismanis
1Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia 23298, USA. timkirodimos@hotmail.com
Objective:
To evaluate hearing results following intratympanic gentamicin perfusion in patients with Ménière's disease.
Materials And Methods:
Middle-ear perfusion of 0.4 ml of gentamicin 40 mg/ml solution was performed in Ménière's disease patients who had previously failed to respond to other medical treatment.
Results:
Between May 1999 and November 2005, 22 patients (mean age 58.5 years) underwent intratympanic gentamicin perfusion. Mean follow up was 30 months. At the first post-perfusion visit (four to six weeks following perfusion), three of the 22 patients (13.63 per cent) had a pure tone average improvement of at least 10 dB, 15 (68.18 per cent) showed no change and four (18.18 per cent) demonstrated a decrease in hearing of more than 10 dB. Regarding speech discrimination scores, one patient (4.54 per cent) exhibited an improvement of at least 15 per cent, 15 (68.18 per cent) showed no change and six (27.27 per cent) showed a decrease of at least 15 per cent. After long-term follow up (12-40 months following perfusion), 10 patients (45.45 per cent) showed stable hearing, and 12 (54.54 per cent) exhibited a pure tone average decrease of more than 10 dB. Six patients (27.27 per cent) showed a speech discrimination score decrease of at least 15 per cent, while 16 (72.72 per cent) had no change. Complete cessation of vertigo was reported by 20 of the 22 patients (90.9 per cent), while two (9.09 per cent) reported episodic vertigo spells.
Conclusion:
Intratympanic gentamicin perfusion provides effective control of vertigo in patients with Ménière's disease. However, significant hearing loss may occur immediately after perfusion; therefore, this treatment should be considered only for patients whose hearing has already been affected by the disease.
