Outcomes in the use of intra-tympanic gentamicin in the treatment of Ménière's disease.
The pathogenesis of Ménière's disease is associated with a disorder of ionic homeostasis, with the pathologic correlate being endolymphatic hydrops. Despite uncertainty as to its particular mode of action, it is accepted wisdom that intra-tympanic gentamicin has a definite therapeutic role in the control of symptoms in patients who fail to respond to medical therapy. This study reports an evaluation of the efficacy of intra-tympanic gentamicin in the treatment of Ménière's disease and also presents a simple, reliable, safe method of administering gentamicin for this purpose. A retrospective review of 56 patients undergoing intra-tympanic gentamicin treatment for Ménière's disease was conducted. Response to treatment was analysed using a patient survey and examination of pure-tone averages. An overall significant improvement in vertigo symptoms of 81.3 per cent was found. There was a 21.4 per cent rate of significant hearing loss, defined as greater than 10 dB, with an average loss in this group of 18.5 dB. A single dose of gentamicin applied directly to the round window resulted in a high rate of control of vertigo, with acceptably low rates of hearing loss.
Flanagan
Sean
S
Department of Otolaryngology, St Vincent's Hospital, Sydney, New South Wales, Australia.
Mukherjee
Payal
P
Tonkin
John
J
D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D005781:Gelatin Sponge, Absorbable; D005839:Gentamicins / Q000008:administration & dosage* / Q000009:adverse effects; D034381:Hearing Loss / Q000209:etiology; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery; D014717:Vertigo / Q000188:drug therapy / Q000209:etiology
D000900:Anti-Bacterial Agents; D005839:Gentamicins