Intratympanic gentamicin injection in Ménière’s disease: our experience
and outcomes
Abstract
Title: Intratympanic gentamicin injection in Ménière’s disease: our
twelve years’ experience and outcomes. Objective: The aim of our study
is to evaluate the effectiveness of intratympanic gentamicin
injection(ITG) on vertigo control with reduced doses and its hearing
effects. Study design: Retrospective study Materials and Method: The
study was conducted at our Otolaryngology Department of AORN “S.G.
Moscati” between January 2005 and January 2015 on 72 patients with
disabling unilateral Meniere’s disease treated with ITG. We use 0.2-0.3
mL of gentamicin sulfate at a concentration of 40mg/ml, injected into
the affected ear through the posterior-inferior quadrant of the tympanic
membrane. The procedure was carried out for three following days. Main
outcome measures: vertigo control and hearing threshold changes after
ITG treatment. Results: In the 98.6% of the patients (n=71) the ITG
produced the full remission of the vertiginous symptoms. In the 91.6%
of cases(n=66) a single treatment (three consequent injections) was
sufficient to control vertigo, in the 5.5% of cases (n=4) two
treatments were necessary to control vertigo and in the 1.3% of
patients(n=1) three treatments were necessary to control vertigo. In no
case we have had hearing loss after ITG procedure. The pre-treatment
pure tone average was 48 db. The post-treatment pure tone average was
49.2 db. This difference was no statistical difference. Conclusion: In
this study we reported high vertigo control, long follow-up and no case
of significant hearing worsening. We consider the three injections in
the following three days with low doses of gentamicin a safe and valid
treatment for Meniere’s disease. Keyword : Meniere’s disease,
intratympanic gentamicin injection, vertigo control, hearing worsening,
aminoglycoside ototoxicity.