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Intratympanic gentamicin compared with placebo for Ménière's disease.
Fernanda de Amesti1, Maria Jesus Santander2, Matias Winter2
1Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile; Proyecto Epistemonikos, Santiago, Chile.
Medwave
|March 24, 2022
Summary
Intratympanic gentamicin may help control vertigo in Ménière
Area of Science:
- Otolaryngology
- Neurology
- Inner Ear Disorders
Background:
- Ménière's disease involves recurrent vertigo, hearing loss, and tinnitus.
- Intratympanic gentamicin is a treatment for severe Ménière's disease.
- Gentamicin therapy's effectiveness and safety are debated, with potential hearing loss risks.
Purpose of the Study:
- To evaluate the efficacy and safety of intratympanic gentamicin for Ménière's disease.
- To synthesize evidence from systematic reviews and primary studies.
- To assess the certainty of evidence regarding treatment outcomes.
Main Methods:
- Systematic search of the Epistemonikos database, including MEDLINE, EMBASE, and Cochrane.
- Data extraction from systematic reviews and reanalysis of primary studies.
- Meta-analysis and GRADE approach for summarizing findings.
Main Results:
- Included 13 systematic reviews and 80 primary studies.
- Intratympanic gentamicin may improve vertigo control.
- Evidence for effects on tinnitus, hearing loss, and vertigo attack frequency is of low to very low certainty.
Conclusions:
- Intratympanic gentamicin shows potential for vertigo management in Ménière's disease.
- The evidence regarding tinnitus, hearing preservation, and attack frequency reduction is uncertain.
- Further high-quality research is needed to clarify treatment benefits and risks.
