Modified titration intratympanic gentamicin injection for unilateral intractable Ménière's disease.
This study looked into the efficacy of a modified titration protocol of intratympanic gentamicin injection (ITG) in the patients with unilateral intractable Ménière's disease (MD). Modified titration protocol of ITG at a low dose (20 mg/mL) was administered to 10 patients with definite unilateral intractable MD. After initial first two fixed ITGs on weekly basis, the patients might or might not be given any more injections, depending on the appearance of unilateral vestibular loss (UVL). ITG was terminated if the patients satisfied the criteria of UVL. All patients were followed-up for at least two years. The effects of ITG on the vertigo attack, functional level scores and postural balance were evaluated. Of the 10 cases, 8 showed the sign of UVL after receiving initial two ITGs and were not given any more intratympanic injections, and the other 2 patients were administered three ITGs. A two-year follow-up revealed that complete and substantial vertigo control was achieved in 9 cases, and limited vertigo control in 1 patient. Hearing level was lowered in 2 patients. The posture stability and functional level scores were improved. Our study showed that the modified titration protocol of ITG at a low dose could effectively control vertigo in patients with unilateral intractable MD.
Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Bo
B
Liu
Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Yang-Ming
YM
Leng
Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Hong
H
Shi
Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Ren-Hong
RH
Zhou
Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Jing-Jing
JJ
Liu
Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China.
Wen-Juan
WJ
Zhang
Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. zhang_lilac@sina.com.
Su-Lin
SL
Zhang
Department of Otolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China. entwjkong@hust.edu.cn.
Wei-Jia
WJ
Kong
D000328:Adult; D004334:Drug Administration Schedule; D007758:Ear, Inner / Q000187:drug effects / Q000382:microbiology / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D005839:Gentamicins / Q000627:therapeutic use*; D006309:Hearing / Q000187:drug effects / Q000502:physiology; D006801:Humans; D000069555:Injection, Intratympanic; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology; D008875:Middle Aged; D004856:Postural Balance / Q000187:drug effects / Q000502:physiology; D011500:Protein Synthesis Inhibitors / Q000627:therapeutic use*; D014717:Vertigo / Q000188:drug therapy* / Q000382:microbiology / Q000473:pathology
D005839:Gentamicins; D011500:Protein Synthesis Inhibitors
Ménière’s disease; gentamicin; injection; inner ear