TY - JOUR
T1 - Intratympanal gentamicin in Meniere's disease
T2 - Effects on individual semicircular canals
AU - Büki, Béla
AU - Jünger, Heinz
N1 - Publisher Copyright:
© 2017 Elsevier B.V.
PY - 2018/2
Y1 - 2018/2
N2 - OBJECTIVE: In this retrospective study the aim of the authors was to examine the effect of gentamicin on the individual semicircular canals after low dose, single injection intratympanal gentamicin therapy in Meniere's disease.METHODS: Data of 32 patients treated between 2011 and 2015 were collected. The high frequency, high acceleration vestibuloocular reflex (VOR) gain was measured in the individual semicircular canals using video head impulse test immediately before the first intratympanal gentamicin instillation and approximately two months later.RESULTS: In all cases 'AAO-HNS Class A' vertigo control could be attained at least for several months. In 13 cases only one instillation was necessary. In the other 19 cases the attacks returned after a few months. In 11 cases the injection had to be repeated a second time, in 4 cases 3 injections, in 2 cases 4, in 1 case 5 injections and in another 6 injections were necessary. The initial VOR gain was normal in all cases and two months after one injection it decreased in average by 40% in a highly significant manner. However, there were cases in which, although the patients became free of attacks, the gain values remained normal.CONCLUSION: It was possible to demonstrate a significant correlation between the gain decrease of the individual canals. There was no prognostic correlation between the initial gain decrease after the first injection and the necessity of further injections. Gain values also decreased slightly but significantly in the lateral and posteriors canals on the contralateral, untreated side, possibly because of the missing disfacilitation from the treated side.
AB - OBJECTIVE: In this retrospective study the aim of the authors was to examine the effect of gentamicin on the individual semicircular canals after low dose, single injection intratympanal gentamicin therapy in Meniere's disease.METHODS: Data of 32 patients treated between 2011 and 2015 were collected. The high frequency, high acceleration vestibuloocular reflex (VOR) gain was measured in the individual semicircular canals using video head impulse test immediately before the first intratympanal gentamicin instillation and approximately two months later.RESULTS: In all cases 'AAO-HNS Class A' vertigo control could be attained at least for several months. In 13 cases only one instillation was necessary. In the other 19 cases the attacks returned after a few months. In 11 cases the injection had to be repeated a second time, in 4 cases 3 injections, in 2 cases 4, in 1 case 5 injections and in another 6 injections were necessary. The initial VOR gain was normal in all cases and two months after one injection it decreased in average by 40% in a highly significant manner. However, there were cases in which, although the patients became free of attacks, the gain values remained normal.CONCLUSION: It was possible to demonstrate a significant correlation between the gain decrease of the individual canals. There was no prognostic correlation between the initial gain decrease after the first injection and the necessity of further injections. Gain values also decreased slightly but significantly in the lateral and posteriors canals on the contralateral, untreated side, possibly because of the missing disfacilitation from the treated side.
KW - Adult
KW - Female
KW - Gentamicins/administration & dosage
KW - Head Impulse Test
KW - Humans
KW - Injection, Intratympanic
KW - Male
KW - Meniere Disease/drug therapy
KW - Protein Synthesis Inhibitors/administration & dosage
KW - Reflex, Vestibulo-Ocular/drug effects
KW - Retrospective Studies
KW - Semicircular Canals/drug effects
KW - Vertigo/drug therapy
UR - http://www.scopus.com/inward/record.url?scp=85014736714&partnerID=8YFLogxK
U2 - 10.1016/j.anl.2017.02.008
DO - 10.1016/j.anl.2017.02.008
M3 - Journal article
C2 - 28292626
SN - 0385-8146
VL - 45
SP - 39
EP - 44
JO - Auris Nasus Larynx
JF - Auris Nasus Larynx
IS - 1
ER -