End-point indicators of low-dose intra-tympanic gentamicin in management of Ménière's disease.
CONCLUSIONS
One-shot, low-dose intra-tympanic gentamicin (ITG) treatment was effective and safe for Ménière's disease (MD) patients. Head thrust test (HTT) and vestibular evoked myogenic potentials (VEMPs) test could be used as endpoint indicators for vertigo control in MD patients.


OBJECTIVE
The present study is to explore end-point indicators of ITG injection in MD.


METHODS
Patients with MD were reviewed from June 2012 to March 2014. Single-shot ITG at a concentration of 30 mg/ml was administered to patients. The sensitivity and specificity of HTT and VEMPs for vertigo control were measured.


RESULTS
All 37 patients with a median follow-up of 26 months were included. Of those 37 patients, 24 patients (64.9%) obtained class A vertigo control and seven patients (18.9%) obtained class B vertigo control. Only six patients had class C control (16.2%). The sensitivity and specificity of HTT for vertigo control were 74.2% and 50.0%. Meanwhile, the sensitivity and specificity of VEMPs threshold were 83.9% and 33.3%. When combined HTT and VEMPs, sensitivity and specificity were 93.5% and 66.7%. Based on the four-tone average thresholds at 0.5, 1, 2, 3 kHz, 78.4% patients had no significant change in PTA and 16.2% patients experienced significant improvement.
a Department of Otology and Skull Base Surgery, Hearing Research Key Lab of Health Ministry of China , Eye & Ear Nose and Throat Hospital, Fudan University , Shanghai , PR China.
Hong
H
Liu
b Department of Otology and Skull Base Surgery , The First Hospital Affiliated to Xi'an Jiaotong University , Xian , PR China.
Ting
T
Zhang
a Department of Otology and Skull Base Surgery, Hearing Research Key Lab of Health Ministry of China , Eye & Ear Nose and Throat Hospital, Fudan University , Shanghai , PR China.
Qianru
Q
Wu
a Department of Otology and Skull Base Surgery, Hearing Research Key Lab of Health Ministry of China , Eye & Ear Nose and Throat Hospital, Fudan University , Shanghai , PR China.
Yibo
Y
Zhang
a Department of Otology and Skull Base Surgery, Hearing Research Key Lab of Health Ministry of China , Eye & Ear Nose and Throat Hospital, Fudan University , Shanghai , PR China.
Chunfu
C
Dai
D000328:Adult; D000368:Aged; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage*; D064087:Head Impulse Test; D006801:Humans; D000069555:Injection, Intratympanic; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D011500:Protein Synthesis Inhibitors / Q000008:administration & dosage*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D058585:Vestibular Evoked Myogenic Potentials; D055815:Young Adult
D005839:Gentamicins; D011500:Protein Synthesis Inhibitors
Middle ear; auditory physiology; outcomes; vestibular system