Nathalie Gabra1, Issam Saliba. 1. Division of Otolaryngology-Head and Neck Surgery, Montreal University Hospital Center, University of Montreal, Montreal, Quebec, Canada.
Abstract
OBJECTIVES: To compare the efficacy of intratympanic injections of methylprednisolone (ITMP) and intratympanic injections of gentamicin (ITG) to control the symptoms of Ménière's disease and to evaluate their effect on hearing level. STUDY DESIGN: A historical cohort study. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Eighty-nine patients affected by Ménière's disease were included in this study, of whom 47 were treated with ITG and 42 were treated with ITMP. Two periods of follow-up were considered: 0 to 6 months and 6 to 12 months after the intratympanic injections (ITI). Mean outcome measurements consisted of control of vertigo attacks, tinnitus, and aural fullness; pure-tone average (PTA); and speech discrimination score (SDS). RESULTS: The 2 groups had the same number of vertigo spells per month before ITI (P = .883). Six to 12 months after ITI, 82.9% of the ITG group and 48.1% of the ITMP group achieved complete control of vertigo (P = .004). There was better control of tinnitus and aural fullness with ITG than with ITMP (P ≤ .002). The 2 groups had a statistically significant difference in hearing level before ITI (P ≤ .001). This difference was no longer present 6 to 12 months after ITI (P > .05). CONCLUSION: Intratympanic injections of gentamicin are more efficient than ITMP in controlling the symptoms of Ménière's disease. The 2 groups ended up without a difference in hearing level after ITI. According to these findings, administrating ITMP to control Ménière's disease seems to be less beneficial than ITG.
OBJECTIVES: To compare the efficacy of intratympanic injections of methylprednisolone (ITMP) and intratympanic injections of gentamicin (ITG) to control the symptoms of Ménière's disease and to evaluate their effect on hearing level. STUDY DESIGN: A historical cohort study. SETTING: Tertiary referral center. SUBJECTS AND METHODS: Eighty-nine patients affected by Ménière's disease were included in this study, of whom 47 were treated with ITG and 42 were treated with ITMP. Two periods of follow-up were considered: 0 to 6 months and 6 to 12 months after the intratympanic injections (ITI). Mean outcome measurements consisted of control of vertigo attacks, tinnitus, and aural fullness; pure-tone average (PTA); and speech discrimination score (SDS). RESULTS: The 2 groups had the same number of vertigo spells per month before ITI (P = .883). Six to 12 months after ITI, 82.9% of the ITG group and 48.1% of the ITMP group achieved complete control of vertigo (P = .004). There was better control of tinnitus and aural fullness with ITG than with ITMP (P ≤ .002). The 2 groups had a statistically significant difference in hearing level before ITI (P ≤ .001). This difference was no longer present 6 to 12 months after ITI (P > .05). CONCLUSION: Intratympanic injections of gentamicin are more efficient than ITMP in controlling the symptoms of Ménière's disease. The 2 groups ended up without a difference in hearing level after ITI. According to these findings, administrating ITMP to control Ménière's disease seems to be less beneficial than ITG.
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