Low dose transtympanic gentamicin treatment for intractable Meniere's disease: a prospective study.
OBJECTIVE
To evaluate the effectiveness of low dose transtympanic gentamicin treatment in Meniere's disease.


METHODS
Prospective study of 20 disable Meniere's patients in Ramathibodi Hospital who received transtympanic gentamicin treatment for Meniere's disease by fixed dose regimen of 12 injections during a period of 4 days. The study took place from March 1999 to December 2004. The hearing and equilibrium guidelines for reporting treatment results in Meniere's disease of the American Academy of Otolaryngology and Head & Neck Surgery (1995) were used. The outcomes of treatment were evaluated at the 6th month. The multivariate repeated measures ANOVA was used for statistical comparisons.


RESULTS
During the 5-year period, there were 20 patients, 9 men, and 11 women. The six-month outcomes of vertigo control, the functional level scale and tinnitus score were significantly improved by the treatment. Whereas, the mid frequency pure tone threshold average and the speech discrimination score were not significantly affected.


CONCLUSIONS
Fixed low dose transtympanic gentamicin treatment was found to be an effective treatment option for patients with disabling or intractable Meniere's disease, with a low incidence of hearing deterioration. The use of this method appears to be practical and has been set as the standard protocol replacing the vestibular surgery in Ramathibodi Hospital.
Kasemsuwan
Lalida
L
Otolaryngology Department, Faculty of Medicine, Ramathibodi Hospital, Bangkok, Thailand.
Jariengprasert
Chanchai
C
Ruencharopen
Suwimol
S
Orathai
Pisamai
P
D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy*; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D018434:Sickness Impact Profile; D014012:Tinnitus / Q000188:drug therapy; D017211:Treatment Failure; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000187:drug effects*; D014717:Vertigo / Q000188:drug therapy
D000900:Anti-Bacterial Agents; D005839:Gentamicins