Iee Ching Wu1, Lloyd B Minor. 1. Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
Abstract
OBJECTIVE: To determine the long-term hearing outcome in patients with intractable vertigo caused by unilateral Ménière's disease who were treated with intratympanic injection of gentamicin. STUDY DESIGN: The study was a longitudinal analysis of hearing and control of vertigo in patients with unilateral Ménière's disease who received intratympanic gentamicin. METHODS: Pure-tone thresholds and speech discrimination scores on audiometry were analyzed, along with the control of vertigo. Criteria described in 1995 by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) were used. Patients treated with intratympanic gentamicin had "definite" Ménière's disease and had intractable vertigo despite optimal medical therapy, no symptoms suggestive of Ménière's disease in the contralateral ear, and serviceable hearing in the contralateral ear. The study analyzed the outcomes of 34 patients for whom follow-up data were available for periods greater than 24 months after intratympanic gentamicin. RESULTS: Complete control of vertigo (AAOHNS Class A) was obtained in 90% of the patients. Profound sensorineural hearing loss occurred as a result of gentamicin injection in 1 of the 34 patients (3%). When data from all patients were grouped together, hearing was improved in 5 (15%), unchanged in 23 (68%), and worse in 6 (17%) patients. This distribution of hearing outcome is similar to that in patients whose symptoms of Ménière's disease were managed with medical measures. Recurrent vertigo developed in 10 patients (29%) at an interval of 4 to 15 months after initially complete control. Treatment with additional intratympanic injection(s) of gentamicin did not result in a change in hearing. CONCLUSION: The risk of hearing loss in patients treated with infrequent intratympanic injection(s) of gentamicin is low.
OBJECTIVE: To determine the long-term hearing outcome in patients with intractable vertigo caused by unilateral Ménière's disease who were treated with intratympanic injection of gentamicin. STUDY DESIGN: The study was a longitudinal analysis of hearing and control of vertigo in patients with unilateral Ménière's disease who received intratympanic gentamicin. METHODS: Pure-tone thresholds and speech discrimination scores on audiometry were analyzed, along with the control of vertigo. Criteria described in 1995 by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) were used. Patients treated with intratympanic gentamicin had "definite" Ménière's disease and had intractable vertigo despite optimal medical therapy, no symptoms suggestive of Ménière's disease in the contralateral ear, and serviceable hearing in the contralateral ear. The study analyzed the outcomes of 34 patients for whom follow-up data were available for periods greater than 24 months after intratympanic gentamicin. RESULTS: Complete control of vertigo (AAOHNS Class A) was obtained in 90% of the patients. Profound sensorineural hearing loss occurred as a result of gentamicin injection in 1 of the 34 patients (3%). When data from all patients were grouped together, hearing was improved in 5 (15%), unchanged in 23 (68%), and worse in 6 (17%) patients. This distribution of hearing outcome is similar to that in patients whose symptoms of Ménière's disease were managed with medical measures. Recurrent vertigo developed in 10 patients (29%) at an interval of 4 to 15 months after initially complete control. Treatment with additional intratympanic injection(s) of gentamicin did not result in a change in hearing. CONCLUSION: The risk of hearing loss in patients treated with infrequent intratympanic injection(s) of gentamicin is low.
Authors: C Martín González; F M González; A Trinidad; A Ibáñez; M Pinilla; A Martínez Ruiz-Coello; A Rodríguez Valiente; C López-Cortijo Journal: Eur Arch Otorhinolaryngol Date: 2010-05-08 Impact factor: 2.503
Authors: Howard W Francis; Ira Papel; Ioan Lina; Wayne Koch; David Tunkel; Paul Fuchs; Sandra Lin; David Kennedy; Robert Ruben; Fred Linthicum; Bernard Marsh; Simon Best; John Carey; Andrew Lane; Patrick Byrne; Paul Flint; David W Eisele Journal: Laryngoscope Date: 2015-08-22 Impact factor: 3.325
Authors: Frank R Lin; Americo A Migliaccio; Thomas Haslwanter; Lloyd B Minor; John P Carey Journal: Ann Otol Rhinol Laryngol Date: 2005-10 Impact factor: 1.547