Meniett therapy: rescue treatment in severe drug-resistant Ménière's disease?
CONCLUSIONS
Our data indicate that Meniett therapy is unlikely to be helpful in the long-term treatment of patients with severe, drug-resistant Ménière's disease (MD) in whom injection of intratympanic gentamicin (ITG) or another destructive procedure would otherwise be performed.


OBJECTIVE
To investigate the value of Meniett therapy in patients with drug-resistant MD referred for injection of ITG.


METHODS
Twelve patients referred for ITG treatment were followed during a 2-month period of Meniett therapy. Symptoms, functional level and hearing status were evaluated using a standardized staging system. Disease-specific quality-of-life measures were obtained before and after Meniett therapy. At the end of the study period, patients were followed for a mean of 37 months, thus providing long-term outcome data.


RESULTS
In two patients, Meniett treatment was interrupted after 1 month because of persistent severe vertigo. In the remaining 10 subjects, we found a significant decrease in the median number of vertigo spells from 10.0/month (25th-75th percentile 4.0-19.0) prior to treatment to 3.0/month (25th-75th percentile 1.5-4.5) after treatment (p = 0.02). There was, however, no improvement in hearing status, tinnitus, functional level or self-perceived dizziness handicap. Long-term (>1 year) follow-up data revealed that only 2 subjects preferred to continue Meniett therapy and that ablative surgery had to be performed in 6/12 study patients.
Boudewyns
A N
AN
Department of Otorhinolaryngology, Head and Neck Surgery, Antwerp University Hospital, University of Antwerp, Antwerp, Belgium. An.Boudewyns@uza.be
Wuyts
F L
FL
Hoppenbrouwers
M
M
Ketelslagers
K
K
Vanspauwen
R
R
Forton
G
G
Van de Heyning
P H
PH
D000328:Adult; D004352:Drug Resistance, Microbial; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage* / Q000627:therapeutic use; D006801:Humans; D015552:Injections, Intralesional; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis* / Q000628:therapy*; D008875:Middle Aged; D008876:Middle Ear Ventilation / Q000379:methods*; D011336:Probability; D011446:Prospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000187:drug effects
D005839:Gentamicins