domingo, 28 de agosto de 2011

Single-shot, low-dose intratympanic gentamicin in Ménière disease: role of vestibular-evoked myogenic potentials and caloric test in the prediction of outcome

fuente de la imagen:
Sercan Gode MDa, Nese Celebisoy MDb, Aycan Akyuz MDa, Feray Gulec MDb, Hale Karapolat MDc, Cem Bilgen PhDa and Tayfun Kirazli MDa

a Department of Otolaryngology, Ege University Medical School, Izmir, Turkey

b Department of Neurology, Ege University Medical School, Izmir, Turkey

c Department of Physical Medicine and Rehabilitation, Ege University Medical School, Izmir, Turkey


The aim of this study was to assess the efficacy and safety of single and low-dose intratympanic gentamicin therapy in patients with Ménière disease and who were monitored both with caloric tests and vestibular-evoked myogenic potentials (VEMPs) to see if VEMPs have an additional role in predicting the efficacy of the drug.
Study design

This is a prospective cohort study.

Tertiary referral center is the study setting.

Twenty-five intractable Ménière disease patients were included as the study group.

Low-dose (16 mg/mL), single-shot intratympanic gentamicin was applied. VEMP and caloric test were applied 2 weeks after the application.
Main outcome measure(s)

Safety and efficacy of protocol were evaluated at the sixth month postoperatively with tonal audiogram and visual analog scale, respectively.

Mean average pure-tone hearing threshold at 0.5, 1, 2, 4, and 8 kHz was 49.6 and 51.0 dB before and after the application, respectively (P > .05).

Mean pretreatment and posttreatment visual analog scale scores of patients were 17.6 mm (10–30 mm) and 74.6 mm (41–100 mm), respectively (P < .01). Posttreatment VEMPs were absent in 17, deteriorated in 2, and not changed in 6 patients.

VEMP was a significant predictor of posttreatment visual analog scale score, whereas caloric test was not (P < .01). Conclusions

Low-dose, single-shot intratympanic gentamicin treatment proved to be effective and safe among intractable Ménière patients.

VEMPs obtained at posttreatment second week were significant predictors of patients posttreatment sixth-month dizziness status and vertigo control.

Corresponding Author Contact Information
Corresponding author. Ege Universitesi Hastanesi,
Kulak Burun Bogaz Bolumu, 35100,
Bornova, Izmir, Turkey.
Tel.: +902323902600; fax: +902323902670.

Fuente: American Journal of Otolaryngology
Volume 32, Issue 5, September-October 2011, Pages 412-416

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