Continuous intratympanic infusion of gentamicin via a microcatheter in Menière's disease.
Between 1995 and 1998, 11 patients with disabling Menière's disease were treated at our institution with a continuous gentamicin infusion into the middle ear via a microcatheter. The patients had frequent attacks of vertigo and vomiting (functional levels 3-5). Hearing threshold on the affected side was significantly worse than on the healthy side (stage 4+5). Gentamicin was applied by a high-precision insulin pump with a flow rate of 40 mg per day directly in front of the round window. Application was stopped as soon as signs of vestibular affection appeared. A good overall control of vertiginous spells was achieved in 8 patients. Eight patients experienced complete hearing loss on the affected side, 1 experienced a slight worsening, and 1 had no hearing change. There was no correlation between the cumulative gentamicin dosage and the hearing loss. Our findings show that in terms of hearing loss and hospitalization time the continuous gentamicin application is inferior to other applications presented in the literature.
Department of Otorhinolaryngology, University of Cologne, Joseph-Stelzmann-Strasse 9, D-50924 Cologne, Germany. jakob.schoendorf@uni-koeln.de
J
J
Schoendorf
P
P
Neugebauer
O
O
Michel
D000287:Administration, Topical; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001309:Auditory Threshold / Q000502:physiology; D002150:Caloric Tests; D002404:Catheterization / Q000295:instrumentation; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use*; D006311:Hearing Disorders / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D007260:Infusion Pumps; D008297:Male; D008575:Meniere Disease / Q000150:complications / Q000188:drug therapy* / Q000601:surgery; D008875:Middle Aged; D011184:Postoperative Period; D011300:Preoperative Care; D016896:Treatment Outcome; D014432:Tympanic Membrane; D014717:Vertigo / Q000175:diagnosis
D000900:Anti-Bacterial Agents; D005839:Gentamicins