Transtympanic gentamicin treatment using Silverstein MicroWick in Ménière's disease patients: long term outcome.
OBJECTIVE
To assess the long term outcome of gentamicin inner-ear perfusion using the Silverstein MicroWick in the treatment of Ménière's disease.


METHODS
Retrospective questionnaire survey of patients and review of medical records.


METHODS
A district general hospital.


METHODS
All 15 patients who completed a minimum follow up of at least 24 months were included.


METHODS
Subjective symptoms, change in hearing thresholds and Glasgow benefit inventory scores.


RESULTS
Based on the American Association of Otolaryngology-Head and Neck Surgery (1995) guidelines for reporting, 80 per cent of respondents obtained class A vertigo control and 20 per cent obtained class B control. Respondents' functional level improved from pre-operative levels of between three and six to post-operative levels of between one and three. Three respondents had pre-operative 'dead ears' and one developed the condition post-operatively. Hearing deteriorated further in three respondents, improved in two and remained unchanged in the rest. Respondents with class A control demonstrated improved quality of life, with a mean Glasgow benefit inventory total score of +34.


CONCLUSIONS
Transtympanic gentamicin therapy via the Silverstein MicroWick results in good vertigo control. Patients should however be made fully aware of the risk of hearing deterioration.
Suryanarayanan
R
R
Department of Otolaryngology, Arrowe Park Hospital, Wirral, Merseyside, UK.
Srinivasan
V R
VR
O'Sullivan
G
G
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D016503:Drug Delivery Systems; D004432:Ear, Middle / Q000503:physiopathology; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage*; D006309:Hearing / Q000187:drug effects*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008575:Meniere Disease / Q000150:complications / Q000188:drug therapy*; D008875:Middle Aged; D012189:Retrospective Studies; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000601:surgery; D014717:Vertigo / Q000188:drug therapy* / Q000209:etiology
D000900:Anti-Bacterial Agents; D005839:Gentamicins