title: Long-term disability of class A patients with Ménière's disease after treatment with intratympanic gentamicin.
abstract: OBJECTIVE
  The main objective of this study was to characterize the residual vestibular symptoms and disability in patients with Ménière's disease who had achieved complete control of vertigo through intratympanic gentamicin treatment. Furthermore, we assessed whether the Functional Level Score prior to treatment reflected the posttreatment symptoms and disability.
  
  
  METHODS
  Prospective.
  
  
  METHODS
  Tertiary medical center.
  
  
  METHODS
  This study involved 103 patients with Ménière's disease treated with intratympanic gentamicin who, after a long-term follow up, have not suffered new vertigo spells and were not subject to any major modification in their treatment.
  
  
  METHODS
  At inclusion and at the last follow-up visit after a minimum of 3 years of ending the treatment, the clinical status (number of vertigo spells), the unsteadiness as well as the disability produced by the disease, symptoms of anxiety, and compensation were asked using specific questionnaires. The results before and after treatment were analyzed using nonparametric tests.
  
  
  RESULTS
  After a 5-year follow-up, complete control of vertigo was obtained in 81% of the patients with Ménière's disease who were treated with intratympanic gentamicin. Of them, 15.5% still complained of unsteadiness. A functional level of 6 or unsteadiness after treatment are related with a nonreduction in disability after long-term control of vertigo spells.
  
  
  CONCLUSIONS
  The efficacy of gentamicin administered intratympanically is high after long-term follow-up as shown by the disappearance of vertigo spells and by the reduction in disability, increase in perception of quality of life, and reduction in anxiety related to vestibular symptoms. Unsteadiness, although an infrequent complaint, determines a level of almost similar severity in those issues. Special care must be taken with patients with a Functional Level Scale score of 6 at the time of beginning treatment.
authors.affiliation: Department of Otorhinolaryngology, Clínica Universitaria de Navarra, University Hospital and Medical School, University of Navarra, Navarra, Spain.
authors.forename: Maria Soledad
authors.initials: MS
authors.lastname: Boleas-Aguirre
authors.forename: Noelia
authors.initials: N
authors.lastname: Sánchez-Ferrandiz
authors.forename: Francisco
authors.initials: F
authors.lastname: Guillén-Grima
authors.forename: Nicolas
authors.initials: N
authors.lastname: Perez
mesh_terms: D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D001301:Audiometry, Pure-Tone; D004185:Disability Evaluation; D004432:Ear, Middle; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy / Q000503:physiopathology / Q000534:rehabilitation*; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D005839:Gentamicins