J T Atlas1, L S Parnes. 1. Department of Otolaryngology, University of Western Ontario, London, Canada.
Abstract
OBJECTIVE: This study aimed to assess the efficacy and morbidity of intratympanic gentamicin titration therapy on patients with intractable unilateral Meniere's disease. STUDY DESIGN: The study design was a retrospective chart review and patient interviews. SETTING: The study was conducted at a tertiary referral ambulatory dizziness clinic at the London Health Sciences Centre, University Campus, from July 1992 to June 1997. INTERVENTION: Eighty-three patients received weekly intratympanic gentamicin injections in their diseased ear. Treatments were terminated after four injections or sooner if patients met clinical or audiologic criteria. Sixty-eight patients were available for detailed follow-up. MAIN OUTCOME MEASURES: Vertigo frequency, hearing status, personal disability ratings, tinnitus level, and caloric responses before and after gentamicin therapy were measured. RESULTS: Eighty-four percent of patients showed complete, and an additional 6% showed substantial, vertigo control. At 24 months, 17% of patients demonstrated a clinically significant (10-dB) reduction in hearing, but 26% showed a significant hearing improvement. Overall, the group showed no combined statistically significant changes in any of the hearing parameters. No patients had an "extreme" drop in hearing (>30 dB). CONCLUSIONS: Intratympanic gentamicin titration therapy provides excellent vertigo control with a low incidence of hearing loss.
OBJECTIVE: This study aimed to assess the efficacy and morbidity of intratympanic gentamicin titration therapy on patients with intractable unilateral Meniere's disease. STUDY DESIGN: The study design was a retrospective chart review and patient interviews. SETTING: The study was conducted at a tertiary referral ambulatory dizziness clinic at the London Health Sciences Centre, University Campus, from July 1992 to June 1997. INTERVENTION: Eighty-three patients received weekly intratympanic gentamicin injections in their diseased ear. Treatments were terminated after four injections or sooner if patients met clinical or audiologic criteria. Sixty-eight patients were available for detailed follow-up. MAIN OUTCOME MEASURES: Vertigo frequency, hearing status, personal disability ratings, tinnitus level, and caloric responses before and after gentamicin therapy were measured. RESULTS: Eighty-four percent of patients showed complete, and an additional 6% showed substantial, vertigo control. At 24 months, 17% of patients demonstrated a clinically significant (10-dB) reduction in hearing, but 26% showed a significant hearing improvement. Overall, the group showed no combined statistically significant changes in any of the hearing parameters. No patients had an "extreme" drop in hearing (>30 dB). CONCLUSIONS: Intratympanic gentamicin titration therapy provides excellent vertigo control with a low incidence of hearing loss.
Authors: Hendrik G Bremer; Ingrid van Rooy; Bas Pullens; Carla Colijn; Inge Stegeman; Hester J van der Zaag-Loonen; Peter Paul van Benthem; Sjaak F L Klis; Wilko Grolman; Tjasse D Bruintjes Journal: Trials Date: 2014-08-18 Impact factor: 2.279