OBJECTIVE: To investigate the outcomes of intratympanic (IT) gentamicin sulfate injection to treat intractable Ménière's disease (MD) using evidence-based methods. DATA SOURCE: Data were retrieved from a MEDLINE search (January 1995 through January 2011). STUDY SELECTION: Selected were English-language articles presenting outcomes of IT gentamicin injection to treat MD that had a prospective study design and an evidence level of II or higher. DATA EXTRACTION: The database was searched using Boolean combinations of the keywords intratympanic, gentamicin, and Ménière's disease. DATA SYNTHESIS: Dichotomous outcomes (success rate and total deafness) were expressed using a Mantel-Haenszel fixed-effects model. Pretreatment and posttreatment pure-tone audiometry results, and word discrimination scores were summarized using data synthesis techniques. CONCLUSION: A critical literature appraisal and meta-analysis shows that IT gentamicin injection can control vertigo in patients with MD who have limited hearing injury. The quality of research in this field has improved remarkably over the years. However, a large-scale randomized controlled trial is warranted to confirm the predictive factors for the effectiveness of IT gentamicin injection in treating MD.
OBJECTIVE: To investigate the outcomes of intratympanic (IT) gentamicin sulfate injection to treat intractable Ménière's disease (MD) using evidence-based methods. DATA SOURCE: Data were retrieved from a MEDLINE search (January 1995 through January 2011). STUDY SELECTION: Selected were English-language articles presenting outcomes of IT gentamicin injection to treat MD that had a prospective study design and an evidence level of II or higher. DATA EXTRACTION: The database was searched using Boolean combinations of the keywords intratympanic, gentamicin, and Ménière's disease. DATA SYNTHESIS: Dichotomous outcomes (success rate and total deafness) were expressed using a Mantel-Haenszel fixed-effects model. Pretreatment and posttreatment pure-tone audiometry results, and word discrimination scores were summarized using data synthesis techniques. CONCLUSION: A critical literature appraisal and meta-analysis shows that IT gentamicin injection can control vertigo in patients with MD who have limited hearing injury. The quality of research in this field has improved remarkably over the years. However, a large-scale randomized controlled trial is warranted to confirm the predictive factors for the effectiveness of IT gentamicin injection in treating MD.