Single-shot, low-dose intratympanic gentamicin in Ménière disease: role of vestibular-evoked myogenic potentials and caloric test in the prediction of outcome.
OBJECTIVE
The aim of this study was to assess the efficacy and safety of single and low-dose intratympanic gentamicin therapy in patients with Ménière disease and who were monitored both with caloric tests and vestibular-evoked myogenic potentials (VEMPs) to see if VEMPs have an additional role in predicting the efficacy of the drug.


METHODS
This is a prospective cohort study.


METHODS
Tertiary referral center is the study setting.


METHODS
Twenty-five intractable Ménière disease patients were included as the study group.


METHODS
Low-dose (16 mg/mL), single-shot intratympanic gentamicin was applied. VEMP and caloric test were applied 2 weeks after the application.


METHODS
Safety and efficacy of protocol were evaluated at the sixth month postoperatively with tonal audiogram and visual analog scale, respectively.


RESULTS
Mean average pure-tone hearing threshold at 0.5, 1, 2, 4, and 8 kHz was 49.6 and 51.0 dB before and after the application, respectively (P > .05). Mean pretreatment and posttreatment visual analog scale scores of patients were 17.6 mm (10-30 mm) and 74.6 mm (41-100 mm), respectively (P < .01). Posttreatment VEMPs were absent in 17, deteriorated in 2, and not changed in 6 patients. VEMP was a significant predictor of posttreatment visual analog scale score, whereas caloric test was not (P < .01).


CONCLUSIONS
Low-dose, single-shot intratympanic gentamicin treatment proved to be effective and safe among intractable Ménière patients. VEMPs obtained at posttreatment second week were significant predictors of patients posttreatment sixth-month dizziness status and vertigo control.
Gode
Sercan
S
Department of Otolaryngology, Ege University Medical School, Izmir, Turkey. sercangode@yahoo.com
Celebisoy
Nese
N
Akyuz
Aycan
A
Gulec
Feray
F
Karapolat
Hale
H
Bilgen
Cem
C
Kirazli
Tayfun
T
D000293:Adolescent; D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002150:Caloric Tests / Q000379:methods*; D004305:Dose-Response Relationship, Drug; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D007267:Injections; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane; D058585:Vestibular Evoked Myogenic Potentials / Q000187:drug effects / Q000502:physiology*; D055815:Young Adult
D000900:Anti-Bacterial Agents; D005839:Gentamicins