Faculty Opinions recommendation of Intratympanic gentamicin treatment of patients with Ménière's disease with normal hearing.

Objective: The aim of this study was to assess the experiences and outcomes of patients receiving intratympanic gentamicin treatment for Ménière's disease in Norfolk, UK.Design: This study was based on a retrospective questionnaire survey and a review of patients' medical records.Setting: Two district hospitals.Participants: All 29 patients treated between 1999 and 2001, with a minimum follow up of two years post-treatment, were included in the study. Twenty-three patients completed the questionnaires (79 per cent response rate).Main outcome measures: Glasgow benefit inventory (GBI) and vertigo symptom scale (VSS) scores, plus change in hearing thresholds.Results: The mean GBI total score was +36, indicating substantial improvement in patients' overall quality of life following gentamicin treatment. The VSS scores demonstrated low levels of vertigo or unsteadiness in treated patients. Three patients suffered deterioration in their hearing thresholds following a single injection of gentamicin. However, 96 per cent of responders stated that they would be willing to have such treatment again, if necessary.Conclusion: Intratympanic gentamicin treatment ought to be offered to Ménière's patients suffering from disabling vertigo, with the proviso that they be made aware of the possibility of hearing deterioration.

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Intratympanic Gentamicin Treatment for Meniere's Disease

Otolaryngology ◽

10.1177/019459989811800505 ◽

1998 ◽

Vol 118 (5) ◽

pp. 589-596 ◽

Cited By ~ 4

Author(s):

William J. Mcfeely ◽

George T. Singleton ◽

Francisco J. Rodriguez ◽

Patrick J. Antonelli

Keyword(s):

Meniere’S Disease ◽

Delivery Systems ◽

Menière’S Disease ◽

Meniere's Disease ◽

Ménière’S Disease ◽

Menière's Disease ◽

Intratympanic Gentamicin ◽

Gentamicin Treatment ◽

Ménière's Disease ◽

Polyethylene Tubing

OBJECTIVES: The purpose of this study was to evaluate the safety and efficacy of a modified intratympanic gentamicin technique in patients with intractable unilateral or bilateral Meniere's disease. METHODS: A retrospective review of 25 consecutive patients who underwent gentamicin treatment for Meniere's disease was conducted between 1992 and 1996. Two separate delivery systems were used during this study, with the last 13 subjects undergoing placement of the new system (flanged polyethylene tubing). RESULTS: Follow-up averaged 23 months. Absence of vertigo spells was reported in 88%, and substantial control was achieved in 12%. Four of five patients with bilateral disease achieved complete control. Results for the two delivery systems were not significantly different. Absence of ice-water caloric response was seen in 75% (15 of 20) patients. Clinically significant sensorineural hearing loss occurred in 5 (20%) of 25 ears. Nonserviceable hearing developed in only two (8%) patients. CONCLUSIONS: Our results support the previously reported efficacy and relative safety of gentamicin infusion therapy for intractable Meniere's disease. Polyethylene tubing may be more advantageous than T-tube delivery because of anatomic concerns in certain patients. (Otolaryngol Head Neck Surg 1998;118:589–96.)

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