Long-term disability of class A patients with Ménière's disease after treatment with intratympanic gentamicin.
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.
Boleas-Aguirre
Maria Soledad
MS
Department of Otorhinolaryngology, Clínica Universitaria de Navarra, University Hospital and Medical School, University of Navarra, Navarra, Spain.
Sánchez-Ferrandiz
Noelia
N
Guillén-Grima
Francisco
F
Perez
Nicolas
N
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
D000900:Anti-Bacterial Agents; D005839:Gentamicins