Effectiveness Of Intratympanic Gentamycin Injection In The Control Of Miniere’s Disease

RUKİYE ÖZÇELİK ERDEM; Mehmet Akif DÜNDAR; ZUHAL GÜL; HAMDİ ARBAĞ

doi:10.56752/Mevmedsci.2023.33

RUKİYE ÖZÇELİK ERDEM,Mehmet Akif DÜNDAR,ZUHAL GÜL,HAMDİ ARBAĞ

Mehmet Akif DÜNDAR: Necmettin Erbakan Üniversitesi Tıp Fakültesi
HAMDİ ARBAĞ: NECMETTİN ERBAKAN ÜNİVERSİTESİ

Year : 2023
Vol : 3
Issue : 2
Page : 72-74

DOI : https://doi.org/10.56752/Mevmedsci.2023.33

ABSTRACT
Purpose: The effectiveness of intratympanic gentamicin (ITG) injection in controlling vertigo and the problems encountered in medically resistant Meniere's patients were investigated.

Materyal ve Metod: Files were reviewed retrospectively between 2000 and 2015. Twelve patients who were diagnosed with Meniere's disease in our clinic and who had ITG injection were included in the study. The diagnosis of Meniere's disease was made in these patients according to the criteria of the American Academy of Otolaryngology Head and Neck Surgery. Patients who underwent ITG were patients with severe sensorineural hearing loss (> 60 dB) unresponsive to medical treatment for at least 6 months. ITG was applied to the symptomatic ear in the bilateral affected patients. ITG was administered to these patients for 5 consecutive days at a dose of 40 mg/dl, 0.5-1 cc. The patients were evaluated according to American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS)vertigo recovery criteria 6 months after the last injection.

Results: The number of patients with complete and significant control of vertigo was 11 (92%). Partial control was achieved in one (8%) patient. Tinnitus control was successful in 5 (41%) patients, and aural fullness control was successful in 8 (66%) patients. Acute vestibular insufficiency and vestibular deafferentation syndrome developed in 10 (81%) patients. Injection-related complications such as myringitis, infection, perforation were not observed.

Conclusion: Intratympanic injections for vertigo control in Meniere's disease seem to be safe, inexpensive, effective and easily applied methods. There is a need for clinical and experimental studies for a specific algorithm on the dose, application period and method of gentamicin administered intratympanically.

Key words: Meniere's disease, vertigo, intratympanic injection, gentamicin

Cite this Article As : Dündar MA, Özçelik Erdem R, Gül Z, Arbağ H. Meniere Hastalarında İntratimpanik Gentamisin Enjeksiyonunun Vertigo Kontrolünü Sağlamadaki Etkinliği. Mev Med Sci. 2023;3(2): 72-74

Conflict of interest : The authors declare that they have no conflict of interest.

This article is published under the CC BY-NC 4.0 license.

Mevlana Tıp Bilimleri
2023, Vol3, Issue2
E-ISSN: 2757-976X

Received : 30.05.2023, Accepted : 07.08.2023 , Published Online : 15.08.2023

References

1. Nedzelski JM, Chiong CM, Fradet G,et al. Intratympanic gentamicin instillation as treatment of unilateral Meniere's disease: update of an ongoing study. Otol Neurotol. 1993;14(3):278-82.
2. Hirsch BE, Kamerer DB. Intratympanic gentamicin therapy for Meniere's disease. Otol Neurotol. 1997;18(1):44-51.
3. Ünlü M, Yiğit Ö, Çınar U,Et Al. Menıere Hastalığında Ventilasyon Tüpü Yolu İle İntratimpanik Gentamisin Uygulaması.K.B.B. ve BBC Dergisi, (10) : 63-66, 2002
4. Thai-Van H, Bounaix M-J, Fraysse B. Meniere’s disease: pathophysiology and treatment. Drugs. 2001;61:1089-102.
5. Baloh RW. Harold Schuknecht and pathology of the ear. OtolNeurotol. 2001;22(1):113-22.
6. Sennaroolu L, Linthicum Jr FH. Histopathology of Ménière's disease. Otol & Neurotol. 2000;21(6):889.
7. Berryhill WE, Graham MD. Chemical and physical labyrinthectomy for Meniere's disease. Otolaryngol Clın North Am. 2002;35(3):675-82.
8. Ödkvist L, Bergenius J, Möller C. When and how to use gentamicin in the treatment of Meniere's disease. Acta Otolaryngol. 1997;117(sup526):54-7.
9. Silverstein H, Arruda J, Rosenberg SI, et al. Direct round window membrane application of gentamicin in the treatment of Meniere’s disease. Otolaryngol Head Neck Surg. 1999;120(5):649-55.
10. Nedzelski JM, Schessel DA, Bryce GE, et al. Chemical labyrinthectomy: local application of gentamicin for the treatment of unilateral Meniere's disease. Otol Neurotol. 1992;13(1):18-22.
11. DeCicco MJ, Hoffer M, Kopke R, et al. Round-window microcatheter-administered microdose gentamicin: Results from treatment of tinnitus associated with Meniere's disease. Int Tinnitus J. 1998;4(2):141-3.
12. Silverstein H, Jackson LE, Rosenberg SI. Silverstein Microwick™ for treatment of inner ear disease. Oper Tech Otolayngol Head Neck Surg. 2001;12(3):144-7.
13. Beck C, Schmidt C. 10 years of experience with intratympanally applied streptomycin (gentamycin) in the therapy of Morbus Meniere. Arch Otorhinolaryngol. 1978;221:149-52.
14. Casani AP, Cerchiai N, Navari E, et al. Intratympanic gentamicin for Meniere’s disease: short-and long-term follow-up of two regimens of treatment. Otolaryngol Head Neck Surg. 2014;150(5):847-52.
15. Harner SG, Kasperbauer JL, Facer GW, et al. Transtympanic gentamicin for Meniere's syndrome. Laryngoscope. 1998;108(10):1446-9.
16. Cenik Z, Cenik A, Doğmuş H. Steroid İlaclar Ve Otorinolarengolojide Kullanımı. Selcuk Med J. 1989, Vol. 5(3).
17. Quaranta A, Aloisi A, De Benedittis G, et al. Intratympanic Therapy for Ménière's Disease: High‐Concentration Gentamicin with Round‐Window Protection. Ann N Y Acad Sci. 1999;884(1):410-24.