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.
Department of Otolaryngology, Arrowe Park Hospital, Wirral, Merseyside, UK.
R
R
Suryanarayanan
V R
VR
Srinivasan
G
G
O'Sullivan
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