KMID : 0361020090520040322
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Korean Journal of Otolaryngology - Head and Neck Surgery 2009 Volume.52 No. 4 p.322 ~ p.326
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Treatment of Meniere¡¯s Disease with Low-Concentration Intratympanic Gentamicin Injection
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Kwon Min-Su
Ahn Joong-Ho Chung Jong-Woo Yoon Tae-Hyun Lee Sung-Bu
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Abstract
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Background and Objectives£º Intratympanic gentamicin injection is used as one of the treatment modalities for medically intractable Meniere¡¯s disease. But the ideal dosage and concentration of gentamicin were not established in consideration of therapeutic efficacy and the risk of postoperative hearing loss. We analyzed the clinical outcome of low-concentration intratympanic gentamicin injection in patients with Meniere¡¯s disease. And we also tried to find factors anticipating for the response to treatment.
Subjects and Method£ºA retrospective review was conducted on 45 subjects who had been diagnosed as ¡®definite¡¯ Meniere¡¯s disease (AAO-HNS, 1995) and had no response to medical treatment over 3 months in our clinic. The concentration of gentamicin was 7 mg/cc, which was very low compared with previous studies. We reviewed postoperative changes on vertigo, tinnitus and hearing by questionnaire and pure tone audiometry. We also analyzed preoperative patients¡¯ characteristics for acquisition of predictive factors of treatment response.
Results£ºVertigo was completely disappeared in 37 (82%) patients and there was no vertigo improvement in 8 (18%) patients despite multiple injections. Tinnitus was controlled in 11 (24%) patients, and aggravated in 4 (8%) patients. A significant postoperative hearing loss over 10 dB occurred in only 6 (13%) patients. Preoperative patients¡¯ hearing threshold, frequency of vertigo, functional level and finding in electrical test, such as electrocochleogram, were not different regarding treatment response.
Conclusion£ºLow-concentration gentamicin was enough to control vertigo and could reduce the risk of postoperative hearing loss in patients with Meniere¡¯s disease.
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KEYWORD
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Meniere¡¯s disease, Gentamicin
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