Ramírez-Arroyo G, Carrillo-Pacheco E

Language: Spanish
References: 9
Page: 220-228
PDF size: 222.76 Kb.

ABSTRACT

Background: Ménière’s disease is a clinical syndrome characterized by spontaneous vertigo attacks, associated with fluctuating neurosensorial hearing loss, tinnitus, and aural fullness. The diagnosis is based on the criteria proposed by the Barany Society. 10 to 20% of patients with Ménière’s disease have intractable vertigo, management alternatives in these cases are endolymphatic sac surgery, infiltration with intratympanic gentamicin, vestibular neurectomy, and labyrinthectomy.
Clinical case: A 62-year old female patient with bilateral Ménière’s disease presented with incapacitating vertigo that did not respond to lifestyle changes nor to treatment with betahistine, diuretics, or steroids. For management of intractable vertigo, the patient received intratympanic gentamicine in August, 2016. After the infiltration, the patient had not presented any vertigo crisis for 3 years and the phonemic discrimination has been stable. As part of a comprehensive medical care, she received vestibular rehabilitation, a hearing aid was adapted, and she received treatment by the psychiatry department. Multidisciplinary management improved quality of life in this patient.
Conclusions: This clinical case exemplifies the use of intratympanic gentamicin as a therapeutic alternative for intractable vertigo, even in the context of socially useful hearing.

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