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Intratympanic gentamicin in Ménière's disease: our experience

Published online by Cambridge University Press:  15 February 2011

L Pérez Delgado ,
J Fraile Rodrigo  and
P Astier Peña
L Pérez Delgado*
Affiliation:
Otorhinolaryngology, Miguel Servet University Hospital, Zaragoza, Spain
J Fraile Rodrigo
Affiliation:
Otorhinolaryngology, Miguel Servet University Hospital, Zaragoza, Spain
P Astier Peña
Affiliation:
Family Medicine Services, Miguel Servet University Hospital, Zaragoza, Spain
*
Address for correspondence: Dr Laura Pérez Delgado, c/ Veracruz No 7, 2°B CP 50019, Zaragoza, Spain E-mail: layipez@hotmail.com
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Abstract

Aims:

To analyse intratympanic gentamicin injection as a treatment option in patients with monolateral Ménière's disease resistant to medical treatment.

Material and methods:

Longitudinal, prospective, descriptive study of response to gentamicin treatment in 71 patients diagnosed with Ménière's disease and treated medically for more than a year, unsuccessfully. American Academy of Otolaryngology-Head and Neck Surgery criteria were used for diagnosis and follow up.

Results:

Complete vertigo control was obtained in 65.6 per cent of patients, and complete or substantial control in 84.37 per cent. Thirteen patients (18.3 per cent) suffered significant hearing loss.

Conclusion:

This intratympanic gentamicin injection protocol enabled effective vertigo control in most patients, and represents a good alternative to more aggressive techniques for the treatment of Ménière's disease which does not respond to medical treatment.

Keywords

VertigoGentamicinTherapeuticsEar, Middle
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 4 , April 2011 , pp. 363 - 369
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Fowler, E. Toxicity of streptomycin for the auditory and vestibular mechanisms. Trans Am Acad Ophthalmol Otolaryngol 1948;52:293–301Google Scholar
2Schuknecht, HF. Ablation therapy in the management of Menière's disease. Acta Otolaryngol Suppl 1957;132:1–42Google ScholarPubMed
3Beck, C, Schmidt, CL. 10 years of experience with intratympanally applied streptomycin (gentamicin) in the therapy of Morbus Menière. Arch Otorhinolaryngol 1978;221:149–52CrossRefGoogle ScholarPubMed
4The Committee on Hearing and Equilibrium. Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. Otolaryngol Head Neck Surg 1995;113:186–7Google Scholar
5Chia, SH, Gamst, AC, Anderson, JP, Harris, JP. Intratympanic gentamicin therapy for Ménière's disease: a meta-analysis. Otol Neurotol 2004;25:544–52Google Scholar
6Minor, LB. Intratympanic gentamicin for control of vertigo in Meniere's disease: vestibular signs that specify completion of therapy. Am J Otol 1999;20:209–19Google ScholarPubMed
7Hirsch, BE, Kamerer, DB. Intratympanic gentamicin therapy for Ménière's disease. Am J Otol 1997;18:44–51Google ScholarPubMed
8Perez, N, Martín, E, García-Tapia, R. Intratympanic gentamicin for intractable Meniere's disease. Laryngoscope 2003;113:456–64Google Scholar
9Nakashima, T, Naganawa, S, Sugiura, M, Teranishi, M, Sone, M, Hayashi, H et al. Visualization of endolymphatic hydrops in patients with Meniere's disease. Laryngoscope 2007;117:415–20CrossRefGoogle ScholarPubMed
10Abou-Halawa, AS, Poe, DS. Efficacy of increased gentamicin concentration for intratympanic injection therapy in Ménière's disease. Otol Neurotol 2002;23:494–502, 502–3Google Scholar
11Kaasinen, S, Pyykkö, I, Ishizaki, H, Aalto, H. Intratympanic gentamicin in Ménière's disease. Acta Otolaryngol 1998;118:294–8Google Scholar
12Rauch, SD, Oas, JG. Intratympanic gentamicin for treatment of intractable Ménière's disease: a preliminary report. Laryngoscope 1997;107:49–55Google Scholar
13Boleas-Aguirre, MS, Sánchez-Ferrandiz, N, Guillén-Grima, F, Perez, N. Long-term disability of class A patients with Ménière's disease after treatment with intratympanic gentamicin. Laryngoscope 2007;117:1474–81Google Scholar
14Stahle, J, Bergman, B. The caloric reaction in Ménière's disease. Laryngoscope 1967;77:1629–43Google Scholar
15Dobie, RA, Snyder, JM, Donaldson, JA. ENG and audiologic findings in patients with Ménière's disease. Acta Otolaryngol 1982;94:19–27CrossRefGoogle Scholar
16Hulshof, JH, Baarsma, EA. Follow-up vestibular examination in Menière's disease. Acta Otolaryngol 1981;92:397–401CrossRefGoogle ScholarPubMed
17Lange, G, Maurer, J, Mann, W. Long-term results after interval therapy with intratympanic gentamicin for Menière's disease. Laryngoscope 2004;114:102–5Google Scholar
18Bertino, G, Durso, D, Manfrin, M, Casati, L, Mira, E. Intratympanic gentamicin in monolateral Meniere's disease: our experience. Eur Arch Otorhinolaryngol 2006;263:271–5Google Scholar
19Cohen-Kerem, R, Kisilevsky, V, Einarson, TR, Kozer, E, Koren, G, Rutka, JA. Intratympanic gentamicin for Menière's disease: a meta-analysis. Laryngoscope 2004;114:2085–91CrossRefGoogle ScholarPubMed
20Carey, J. Intratympanic gentamicin for the treatment of Meniere's disease and other forms of peripheral vertigo. Otolaryngol Clin North Am 2004;37:1075–90CrossRefGoogle ScholarPubMed
21Harner, SG, Driscoll, CL, Facer, GW, Beatty, CW, McDonald, TJ. Long-term follow-up of transtympanic gentamicin for Ménière's syndrome. Otol Neurotol 2001;22:210–14Google Scholar
22Flanagan, S, Mukherjee, P, Tonkin, J. Outcomes in the use of intra-tympanic gentamicin in the treatment of Ménière's disease. J Laryngol Otol 2006;120:98–102Google Scholar
23Wu, IC, Minor, LB. Long-term hearing outcome in patients receiving intratympanic gentamicin for Ménière's disease. Laryngoscope 2003;113:815–20Google Scholar
24Peterson, WM, Isaacson, JE. Current management of Ménière's disease in an only hearing ear. Otol Neurotol 2007;28:696–9CrossRefGoogle Scholar
25Blakley, BW. Update on intratympanic gentamicin for Ménière's disease. Laryngoscope 2000;110:236–40CrossRefGoogle ScholarPubMed
26Kaplan, DM, Nedzelski, JM, Chen, JM, Shipp, DB. Intratympanic gentamicin for the treatment of monolateral Ménière's disease. Laryngoscope 2000;110:1298–305Google Scholar
27Assimakopoulos, D, Patrikakos, G. Treatment of Ménière's disease by intratympanic gentamicin application. J Laryngol Otol 2003;117:10–16Google Scholar