[Follow-up assessment of intratympanic gentamicin therapy and Saccotomia in Menière's Disease].
BACKGROUND
The intratympanic application of ototoxic antibiotics and saccotomia have been well documented in severe cases of one-sided Menière's disease for 30 years now. Both treatment methods are still subject to controversial discussion.


METHODS
This study includes 8 patients suffering from persistent one-sided Menière's disease after treatment with gentamicin application and additional saccotomia (n=2). We performed follow-up visits including the assessment of hearing ability, vestibular function and cranial MRI, 2-10 years after onset of treatment.


RESULTS
After therapeutic interventions 7 patients reported to be healed of their symptom vertigo. In 4 patients the gentamicin-treated vestibular organ did not respond to thermic stimulus at the time of follow-up examination. Auditory threshold shift was observed in 3 patients (1 permanent, 2 temporary), whereas hearing threshold improved in 2 patients. Tinnitus was attenuated in 3 patients, while 1 patient suffered from posttherapeutic onset of tinnitus. Morphological and structural changes due to Menière's disease and treatment procedures were ruled out by cranial MRI.


CONCLUSIONS
The intratympanic application of ototoxic medication is a safe and effective treatment method in severe cases of Menière's disease. Saccotomia should be considered as therapeutic regimen for persistent symptoms after repeated application of gentamicin.
Tauber
S
S
Klinik und Poliklinik für Hals-, Nasen- und Ohrenkranke, Ludwig-Maximilians-Universität München, Germany.
Jäger
L
L
Issing
W J
WJ
D000368:Aged; D001309:Auditory Threshold / Q000187:drug effects; D004432:Ear, Middle / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage* / Q000009:adverse effects; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008575:Meniere Disease / Q000209:etiology / Q000628:therapy*; D008875:Middle Aged; D010342:Patient Acceptance of Health Care; D011788:Quality of Life; D012444:Saccule and Utricle / Q000601:surgery*; D014012:Tinnitus / Q000188:drug therapy / Q000209:etiology; D014724:Vestibular Function Tests
D005839:Gentamicins