2012, Number 2
Otorrinolaringología 2012; 57 (2)
Gentamicina intratimpánica en dosis bajas para el control del vértigo en enfermedad de Ménière resistente al tratamiento médico
Gallardo FMA, Ruiz GP, Vera MC
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ABSTRACTObjectives: To establish the effectiveness of low-dose intratympanic gentamicin treatment (a total dose being 4-8 mg) for the control of vertigo caused by Meniere’s disease resistant to medical treatment, as well as to determine the treatment’s impact on hearing abilities.
Patients and methods: This is a longitudinal prospective study. Seventeen patients unresponsive to medical therapy (11 female and 6 male) were treated with 4-8 mg of gentamicin (4 mg per dose). Deafferentiation signs were checked including spontaneous and head-shaking nystagmus, and audiometric control of frequencies of 0.5, 1, 2 and 3 kHz. A follow-up lasting one and a half years was carried out. The criteria established by the 1995 AAO-HNS Committee of Hearing and Equilibrium were used.
Results: Complete control of vertigo (AAO-HNS Class A) was obtained in 14 patients (82%), a significant control was achieved in 2 patients (AAOHNS Class B), and vertigo was not controlled in just one (AAO-HNS Class C). Hearing loss worse than 10 dB occurred in 12%, and an improvement of more than 10 dB in 12%, whereas in 76% of the cases hearing remained unchanged. The intensity and duration of tinnitus decreased in 36% of the patients, whereas it remained the same in the remaining 64%.
Conclusions: The low-dose intratympanic gentamicin treatment is a safe, efficient, low-cost, low-risk method presenting a reduced risk of hypoacusis and thus it should be regarded as the primary treatment for vertigo control when caused by Meniere’s disease resistant to medical treatment.