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Transtympanic gentamicin treatment using Silverstein MicroWick in Ménière's disease patients: long term outcome

Published online by Cambridge University Press:  04 June 2008

R Suryanarayanan*
Affiliation:
Department of Otolaryngology, Arrowe Park Hospital, Wirral, Merseyside, UK
V R Srinivasan
Affiliation:
Department of Otolaryngology, Arrowe Park Hospital, Wirral, Merseyside, UK
G O'Sullivan
Affiliation:
Department of Otolaryngology, Arrowe Park Hospital, Wirral, Merseyside, UK
*
Address for correspondence: Mr R Suryanarayanan, ENT Department, Arrowe Park Hospital, Arrowe Park Road, Upton, Wirral, CH49 5PE. E-mail: [email protected]

Abstract

Objective:

To assess the long term outcome of gentamicin inner-ear perfusion using the Silverstein MicroWick™ in the treatment of Ménière's disease.

Study design:

Retrospective questionnaire survey of patients and review of medical records.

Setting:

A district general hospital.

Participants:

All 15 patients who completed a minimum follow up of at least 24 months were included.

Main outcome measures:

Subjective symptoms, change in hearing thresholds and Glasgow benefit inventory scores.

Results:

Based on the American Association of Otolaryngology-Head and Neck Surgery (1995) guidelines for reporting, 80 per cent of respondents obtained class A vertigo control and 20 per cent obtained class B control. Respondents' functional level improved from pre-operative levels of between three and six to post-operative levels of between one and three. Three respondents had pre-operative ‘dead ears’ and one developed the condition post-operatively. Hearing deteriorated further in three respondents, improved in two and remained unchanged in the rest. Respondents with class A control demonstrated improved quality of life, with a mean Glasgow benefit inventory total score of +34.

Conclusion:

Transtympanic gentamicin therapy via the Silverstein MicroWick results in good vertigo control. Patients should however be made fully aware of the risk of hearing deterioration.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2008

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Footnotes

Presented at the otology section of the Royal Society of Medicine, 2 March 2007, London, UK.

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