Document Type: Special Articles

Authors

1 Department and Research Center of Otolaryngology-Head and Neck Surgery, Hazrat-e-Rasool Akram Hospital, Iran University of Medical Sciences, Tehran, Iran.

2 Department of Otolaryngology-Head and Neck Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

3 Department and Research Center of Otolaryngology-Head and Neck Surgery, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.

Abstract

Background: Ménière’s disease  has been  remained  as a difficult therapeutic  challenge. The  present  study aimed to   determine    the effects of  one-shot low-dosage intratympanic   gentamicin   on  vertigo control, auditory outcomes  and  findings of computerized  dynamic posturography  and   vestibular  evoked  myogenic potentials in patients with unilateral Ménière’s disease.Methods: In a prospective  clinical study, 30 patients  with unilateral  Ménière’s  disease  were  treated  with one-shot intratympanic injection of 20 milligrams gentamicin. Main outcome     measures  included clinical,  audiometric, postural   and  vestibular  outcomes evaluated 1 and  9 months after the treatment.Results:  Mean  vertigo  attacks  frequency,  pure   tone average  threshold  and functional level scale significantly decreased after the treatment (P < 0.05). Effective vertigo control (class A and B) obtained in 95.8% of the patients. In total, 75% of patients  reported decrease  in both  aural fullness and  tinnitus.    Vestibular  evoked myogenic potentials  became  absent  in all the  patients  but  four of them. Posturographic scores were improved after the treatment.Conclusion: One-shot  low-dosage  gentamicin  was effective   in   controlling vertigo attacks  in Ménière’s disease  and  has  useful  effects on  aural  fullness and tinnitus  of patients  as well. Postural and  vestibular tests only have adjunctive role for monitoring  therapeutic responses in intratympanic gentamicin-therapy.