Intratympanic mixture gentamicin and dexamethasone versus dexamethasone for unilateral Meniere's disease
Ozturk, Kayhan and Ata, Nurdogan
Loading
Abstract
Objective: This study aimed to determine the effectiveness of an
intratympanic (IT) injection of a mixture of gentamicin and
dexamethasone compared with intratympanic dexamethasone (ITD) for
controlling vertigo and protecting the hearing level of Meniere's
disease patients who have persistent vertigo attacks, despite medical
treatment.
Methods: Thirty eight patients with intractable Meniere's disease were
included in this study.
Twenty-one patients were treated with IT mixture gentamicin and
dexxamethasone injection; seventeen patients were treated with ITD. Pre-
and post-treatment audiograms were compared with pure-tone averages.
Control of vertigo was classified according to the American Academy of
Otolaryngology Head and Neck Surgery (AAO-HNS) vertigo control index.
Results: In the mixture group single IT injection was administered in 18
patients (85.7\%), 2 injections were administered in 2 patients (9.5\%)
and 3 injections were administered in one patient (4.8\%). In the ITD
group IT injection was performed 3 times (days 1,3,5) at intervals. The
mean number of intervals per patient was 3,41 (range 1-6).
Two years after IT treatment there was better control of vertigo in
mixture group than in ITD group; 81\% of mixture group and 70,6\% of the
ITD group achieved satisfactory control of vertigo (p = 0,0286).
Audiology results of mixture group showed 20 patients (95,24\%) with
unchanged hearing and 1 patient (4,76\%) with only 10-decibel
deteriorated hearing. There was no worsening of hearing in the ITD
group.
Conclusion: The results of this study showed that an IT injection of a
mixture of gentamicin and dexamethasone in intractable Meniere's disease
cases is more effective than ITD for vertigo control.... Show more Show less