[Efficacy of intratympanic gentamicin and dexamethasone in the treatment of intractable Meniere's disease].

Objective:To investigate the efficacy and safety of low-dose intratympanic gentamicin (ITG) compared with intratympanic dexamethasone (ITD) in patients with intractable Meniere's disease (MD). Method:Seventy patients affected by definite unilateral MD were enrolled. 1 ml of gentamicin sulfate(40 g/L) was buffered with 0.5 ml of sodium bicarbonate to obtain a 6.4 pH solution with 26.7 g/L concentration. Thirty-five patients were treated with the buffered gentamicin solution on every week for 2 times. Thirty-five patients were treated with ITD (5 mg) in the first two days, and then every week for 4 weeks. At 2-year follow-up, mean outcome measurements consisted of control of vertigo attacks, pure tone average (PTA), dizziness handicap inventory and tinnitus handicap inventory.Result:Among 34 cases with complete follow-up data in the ITG group, complete control of vertigo (class A) was achieved in 27 patients and substantial control of vertigo (class B) in 5 patients. Among 32 cases with complete follow-up data in the ITD group, class A and B were achieved in 13 and 6 patients respectively (P< 0.05). There were no statistically significant variations between the two groups in PTA and THI (t= 1.737 and t=－0.197, P> 0.05).
Conclusion: Low-dose ITG achieves better outcome than ITD in the control of vertigo attacks in patients suffering from unilateral intractable MD, with a very low incidence of hearing deterioration. Copyright© by the Editorial Department of Journal of Clinical Otorhinolaryngology Head and Neck Surgery.