Hostname: page-component-586b7cd67f-l7hp2 Total loading time: 0 Render date: 2024-11-24T07:30:22.589Z Has data issue: false hasContentIssue false
  • English
  • Français

Intratympanic gentamicin in Ménière's disease: our experience

Published online by Cambridge University Press:  15 February 2011

L Pérez Delgado ,
J Fraile Rodrigo  and
P Astier Peña
L Pérez Delgado*
Affiliation:
Otorhinolaryngology, Miguel Servet University Hospital, Zaragoza, Spain
J Fraile Rodrigo
Affiliation:
Otorhinolaryngology, Miguel Servet University Hospital, Zaragoza, Spain
P Astier Peña
Affiliation:
Family Medicine Services, Miguel Servet University Hospital, Zaragoza, Spain
*
Address for correspondence: Dr Laura Pérez Delgado, c/ Veracruz No 7, 2°B CP 50019, Zaragoza, Spain E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Aims:

To analyse intratympanic gentamicin injection as a treatment option in patients with monolateral Ménière's disease resistant to medical treatment.

Material and methods:

Longitudinal, prospective, descriptive study of response to gentamicin treatment in 71 patients diagnosed with Ménière's disease and treated medically for more than a year, unsuccessfully. American Academy of Otolaryngology-Head and Neck Surgery criteria were used for diagnosis and follow up.

Results:

Complete vertigo control was obtained in 65.6 per cent of patients, and complete or substantial control in 84.37 per cent. Thirteen patients (18.3 per cent) suffered significant hearing loss.

Conclusion:

This intratympanic gentamicin injection protocol enabled effective vertigo control in most patients, and represents a good alternative to more aggressive techniques for the treatment of Ménière's disease which does not respond to medical treatment.

Keywords

VertigoGentamicinTherapeuticsEar, Middle
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 125 , Issue 4 , April 2011 , pp. 363 - 369
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Fowler, E. Toxicity of streptomycin for the auditory and vestibular mechanisms. Trans Am Acad Ophthalmol Otolaryngol 1948;52:293–301Google Scholar
2Schuknecht, HF. Ablation therapy in the management of Menière's disease. Acta Otolaryngol Suppl 1957;132:1–42Google ScholarPubMed
3Beck, C, Schmidt, CL. 10 years of experience with intratympanally applied streptomycin (gentamicin) in the therapy of Morbus Menière. Arch Otorhinolaryngol 1978;221:149–52CrossRefGoogle ScholarPubMed
4The Committee on Hearing and Equilibrium. Committee on Hearing and Equilibrium guidelines for the evaluation of results of treatment of conductive hearing loss. American Academy of Otolaryngology-Head and Neck Surgery Foundation, Inc. Otolaryngol Head Neck Surg 1995;113:186–7Google Scholar
5Chia, SH, Gamst, AC, Anderson, JP, Harris, JP. Intratympanic gentamicin therapy for Ménière's disease: a meta-analysis. Otol Neurotol 2004;25:544–52Google Scholar
6Minor, LB. Intratympanic gentamicin for control of vertigo in Meniere's disease: vestibular signs that specify completion of therapy. Am J Otol 1999;20:209–19Google ScholarPubMed
7Hirsch, BE, Kamerer, DB. Intratympanic gentamicin therapy for Ménière's disease. Am J Otol 1997;18:44–51Google ScholarPubMed
8Perez, N, Martín, E, García-Tapia, R. Intratympanic gentamicin for intractable Meniere's disease. Laryngoscope 2003;113:456–64Google Scholar
9Nakashima, T, Naganawa, S, Sugiura, M, Teranishi, M, Sone, M, Hayashi, H et al. Visualization of endolymphatic hydrops in patients with Meniere's disease. Laryngoscope 2007;117:415–20CrossRefGoogle ScholarPubMed
10Abou-Halawa, AS, Poe, DS. Efficacy of increased gentamicin concentration for intratympanic injection therapy in Ménière's disease. Otol Neurotol 2002;23:494–502, 502–3Google Scholar
11Kaasinen, S, Pyykkö, I, Ishizaki, H, Aalto, H. Intratympanic gentamicin in Ménière's disease. Acta Otolaryngol 1998;118:294–8Google Scholar
12Rauch, SD, Oas, JG. Intratympanic gentamicin for treatment of intractable Ménière's disease: a preliminary report. Laryngoscope 1997;107:49–55Google Scholar
13Boleas-Aguirre, MS, Sánchez-Ferrandiz, N, Guillén-Grima, F, Perez, N. Long-term disability of class A patients with Ménière's disease after treatment with intratympanic gentamicin. Laryngoscope 2007;117:1474–81Google Scholar
14Stahle, J, Bergman, B. The caloric reaction in Ménière's disease. Laryngoscope 1967;77:1629–43Google Scholar
15Dobie, RA, Snyder, JM, Donaldson, JA. ENG and audiologic findings in patients with Ménière's disease. Acta Otolaryngol 1982;94:19–27CrossRefGoogle Scholar
16Hulshof, JH, Baarsma, EA. Follow-up vestibular examination in Menière's disease. Acta Otolaryngol 1981;92:397–401CrossRefGoogle ScholarPubMed
17Lange, G, Maurer, J, Mann, W. Long-term results after interval therapy with intratympanic gentamicin for Menière's disease. Laryngoscope 2004;114:102–5Google Scholar
18Bertino, G, Durso, D, Manfrin, M, Casati, L, Mira, E. Intratympanic gentamicin in monolateral Meniere's disease: our experience. Eur Arch Otorhinolaryngol 2006;263:271–5Google Scholar
19Cohen-Kerem, R, Kisilevsky, V, Einarson, TR, Kozer, E, Koren, G, Rutka, JA. Intratympanic gentamicin for Menière's disease: a meta-analysis. Laryngoscope 2004;114:2085–91CrossRefGoogle ScholarPubMed
20Carey, J. Intratympanic gentamicin for the treatment of Meniere's disease and other forms of peripheral vertigo. Otolaryngol Clin North Am 2004;37:1075–90CrossRefGoogle ScholarPubMed
21Harner, SG, Driscoll, CL, Facer, GW, Beatty, CW, McDonald, TJ. Long-term follow-up of transtympanic gentamicin for Ménière's syndrome. Otol Neurotol 2001;22:210–14Google Scholar
22Flanagan, S, Mukherjee, P, Tonkin, J. Outcomes in the use of intra-tympanic gentamicin in the treatment of Ménière's disease. J Laryngol Otol 2006;120:98–102Google Scholar
23Wu, IC, Minor, LB. Long-term hearing outcome in patients receiving intratympanic gentamicin for Ménière's disease. Laryngoscope 2003;113:815–20Google Scholar
24Peterson, WM, Isaacson, JE. Current management of Ménière's disease in an only hearing ear. Otol Neurotol 2007;28:696–9CrossRefGoogle Scholar
25Blakley, BW. Update on intratympanic gentamicin for Ménière's disease. Laryngoscope 2000;110:236–40CrossRefGoogle ScholarPubMed
26Kaplan, DM, Nedzelski, JM, Chen, JM, Shipp, DB. Intratympanic gentamicin for the treatment of monolateral Ménière's disease. Laryngoscope 2000;110:1298–305Google Scholar
27Assimakopoulos, D, Patrikakos, G. Treatment of Ménière's disease by intratympanic gentamicin application. J Laryngol Otol 2003;117:10–16Google Scholar