Evaluation of the effect of intratympanic injection of gentamicin for resistant cases of Meniere’s disease on hearing and vestibular functions

被引:0
作者
Baki F. [1 ]
Asal S. [2 ]
Shewel Y. [1 ]
Galal A. [1 ]
机构
[1] Department of Otorhinolaryngology, Faculty of Medicine, Alexandria University, Alexandria
[2] Unit of Audiology, Otorhinolaryngology Department, Faculty of Medicine, Alexandria University, 182 Omar Lofty Street Sporting Tram Station, Alexandria
关键词
cervical vestibular-evoked myogenic potential; gentamicin; intratympanic injection; Meniere’s disease; ocular vestibular-evoked myogenic potential; otolith;
D O I
10.4103/1012-5574.156099
中图分类号
学科分类号
摘要
Abstract Objectives: This study was performed to investigate the effect of a single minimal dose of intratympanic injection (IT) gentamicin on hearing and otolithic function, mainly on the utricle and saccule independently. Patients and methods: Our study was performed on 10 patients with definite Meniere’s disease diagnosed according to AAO-HNS criteria and who had been showing resistance to medical treatment for more than 6 months with persistent vertigo affecting their lifestyle. IT of gentamicin was given under local anesthesia through direct perfusion in a single dose of 12 mg (0.3 ml of 40 mg/ml) unilaterally on the lesion side. Preinjection evaluation included history, otoscopy, formal pure tone audiometry (PTA), and tympanometry. In addition, cervical vestibular-evoked myogenic potential (cVEMP) and oVEMP were tested. One month after injection, PTA and both VEMP tests were again carried out. Data before and after injection were analyzed and correlated. Results: No overall significant effect on hearing was found. IT gentamicin had significant effect on cVEMPs with 100% abolition, as well as a statistically significant effect on oVEMP with 70% abolition and distortion of the remaining 30%. In these remaining 30% latencies and amplitudes, there was no significant difference in values before and after injection. Conclusion: A 12 mg single dose of gentamicin can abolish otolithic function without affecting hearing. © 2015, The Egyptian Oto - Rhino - Laryngological Society.
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页码:135 / 139
页数:4
相关论文
共 19 条
[1]  
Kasemsuwan L., Jariengprasert C., Chaturapatranont S., Transtympanic gentamicin treatment in Meniere’s disease: a preliminary report, J Med Assoc Thai, 89, pp. 979-985, (2006)
[2]  
Klockhoff I., Lindblom U., Stahle J., Diuretic treatment of Meniere disease. Long-term results with chlorthalidone, Arch Otolaryngol, 100, pp. 262-265, (1974)
[3]  
Brown J.S., A ten year statistical follow-up of 245 consecutive cases of endolymphatic shunt and decompression with 328 consecutive cases of labyrinthectomy, Laryngoscope, 93, pp. 1419-1424, (1983)
[4]  
Schuknecht H.F., Ablation therapy in the management of Meniere’s disease, Acta Otolaryngol Suppl, 132, pp. 1-42, (1957)
[5]  
Lange G., Gentamicin and other ototoxic antibiotics for the transtympanic treatment of Meniere’s disease, Arch Otorhinolaryngol, 246, pp. 269-270, (1989)
[6]  
Kimura R.S., Distribution, structure, and function of dark cells in the vestibular labyrinth, Ann Otol Rhinol Laryngol, 78, pp. 542-561, (1969)
[7]  
Nedzelski J.M., Chiong C.M., Fradet G., Schessel D.A., Bryce G.E., Pfleiderer A.G., Intratympanic gentamicin instillation as treatment of unilateral Meniere’s disease: update of an ongoing study, Am J Otol, 14, pp. 278-282, (1993)
[8]  
Kaplan D.M., Nedzelski J.M., Chen J.M., Shipp D.B., Intratympanic gentamicin for the treatment of unilateral Meniere’s disease, Laryngoscope, 110, pp. 1298-1305, (2000)
[9]  
Pullens B., van Benthem P.P., Intratympanic gentamicin for Meniere’s disease or syndrome, Cochrane Database Syst Rev, 3, (2011)
[10]  
Kasemsuwan L., Jariengprasert C., Ruencharopen S., Orathai P., Low dose transtympanic gentamicin treatment for intractable Meniere’s disease: a prospective study, J Med Assoc Thai, 90, pp. 327-334, (2007)