Hearing results and quality of life after streptomycin/dexamethasone perfusion for meniere's disease

Shea, Paul F.; Richey, Phyllis A.; Wan, Jim Y.; Stevens, Suzanne R.

doi:10.1002/lary.22362

Cited by 23 publications

(13 citation statements)

References 40 publications

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“…Shea et al [19] used IT low-dose streptomycin/ high-dose dexamethasone mixture plus intravenous dexamethasone combination for 3 days in Meniere's disease patients, and found the vertigo control rate as 88%, and hearing loss rate as 15.7%. It has been known that corticosteroids pass into the inner ear and attach to their own receptors.…”

Section: Discussionmentioning

confidence: 99%

Selective Window Application of Gentamicin Dexamethasone in Meniere's Disease

Ardıç

Tümkaya²,

Aykal³

et al. 2017

Int Adv Otol

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OBJECTIVE:The purpose of the study is to prevent hearing loss when using intratympanic (IT) gentamicin for intractable Meniere's disease. MATERIALS and METHODS:It is a retrospective case review study. Twenty five patients who had definite Meniere's disease and had either selective window application or weekly IT gentamicin were included into the study. First group (selective) had dexamethasone on the round window and gentamicin on oval window during exploratory tympanotomy procedure. The second group had IT gentamicin at weekly intervals. The degree of caloric weakness (CW), average hearing level in low pitch (HLP) (250, 500, 1000, 2000 Hz) and high pitch (HHP) (4000, 6000, 8000 Hz) were compared before and after treatment. The need for further treatment was noted. RESULTS:In the first group, the average HLP was increased from 51.6±7dB to 52.2±5.6 dB. The average HHP was increased 41.96±20.2 dB to 47.2±18.3 dB after treatment. The CW changed from 37.6±23.9 % to 54.6±30.6 %. In the second group, the average HLP was increased from 56.3±10.5 dB to 61.65±18.3 dB. The average HHP was increased 59.05±17.4 dB to 69.4±21.98 dB after treatment. The CW changed from 45.8±22.3% to 71.53±29.63 %. Both methods had statisticaly significant increase in caloric weakness. But only IT gentamicin led a significant hearing loss in HHP. CONCLUSION:The use of dexamethasone and gentamycin via different windows in the middle ear is safe and effective method for Meniere's disease in the short term. Application of dexamethasone protects not only the hearing cells but vestibular cells also.

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Section: Discussionmentioning

confidence: 99%

Selective Window Application of Gentamicin Dexamethasone in Meniere's Disease

Ardıç

Tümkaya²,

Aykal³

et al. 2017

Int Adv Otol

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“…Aminoglycoside (AG) antibiotics such as gentamicin, neomycin, amikacin, kanamycin, tobramycin, and others are useful agents in the treatment of both serious bacterial nfections (1) and Ménière's disease (2,3). These antimicrobials are commonly used worldwide because they are less expensive than other antibiotics, and in some countries, they are less regulated by prescription-only sale.…”

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confidence: 99%

Mitochondria-Targeted Antioxidant MitoQ Reduces Gentamicin-Induced Ototoxicity

Ojano-Dirain¹,

Antonelli²,

Prell³

2014

Otology &Amp; Neurotology

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“…The authors used the MD Outcome Questionnaire survey to analyze treatment outcomes. Although they reported that 88% of the patients had improvements in their "vertigo subscore", a considerable amount of hearing loss (17.9%) occurred in these patients [20] . We think that an ideal combination therapy should incorporate the beneficial effects of both agents while minimizing their side effects.…”

Section: Discussionmentioning

confidence: 95%

Cochlear and Vestibular Effects of Combined Intratympanic Gentamicin and Dexamethasone

Günerı

Olgun²,

Aslıer³

et al. 2017

Int Adv Otol

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OBJECTIVE:The aim of this study is to evaluate the effects of an intratympanic gentamicin-dexamethasone combination on the inner ear. MATERIALS and METHODS:Twenty-six Wistar albino rats were divided into four groups: Group I (Control), group II (Intratympanic dexamethasone; ITD), group III (Intratympanic gentamicin; ITG), and group IV (Intratympanic gentamicin and dexamethasone; ITGD). On the first day after basal auditory brainstem response (ABR) measurements, the ITG group received 0.03 mL of intratympanic gentamicin (26.7 mg/mL). Intratympanic injection of 0.06 mL of a solution containing 13.35 mg/mL gentamicin and 2 mg/mL dexamethasone was performed in the ITGD group. 0.03 mL of physiological intratympanic serum and dexamethasone (4 mg/mL) was applied in control and ITD groups, respectively. On the 7 th day, ABR measurements were repeated and vestibular functions were evaluated. On the 21 th day, ABR and vestibular tests were repeated, and the animals were sacrificed for histopathological investigation. RESULTS:The ITG group's hearing thresholds deteriorated in all frequencies. The ITGD group's hearing thresholds were significantly better than the ITG group, except at 8 kHz on the 7 th day and in all frequencies at the 21 th day measurements. The vestibular function scores of the ITG and ITGD groups were higher than the controls. Apoptotic changes were seen in cochlea, spiral ganglion, and vestibule of the ITG group. Cochlear and vestibular structures were well preserved in the ITGD group, similar to the controls. CONCLUSION:The ITGD combination led to a significant hearing preservation. Although in subjective vestibular tests, it seemed that vestibulotoxicity was present in both ITG and ITGD groups the histopathological investigations revealed no signs of vestibulotoxicity in the ITGD group in contrast to the ITG group. Further studies using a combination of different concentrations of gentamicin and dexamethasone are needed.

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Hearing results and quality of life after streptomycin/dexamethasone perfusion for meniere's disease

Abstract: Streptomycin/dexamethasone inner ear perfusion is as safe to the hearing of patients with Meniere's disease as other aminoglycoside regimens and provides a significant improvement in quality of life.

Cited by 23 publications

References 40 publications

Selective Window Application of Gentamicin Dexamethasone in Meniere's Disease

Selective Window Application of Gentamicin Dexamethasone in Meniere's Disease

Mitochondria-Targeted Antioxidant MitoQ Reduces Gentamicin-Induced Ototoxicity

Cochlear and Vestibular Effects of Combined Intratympanic Gentamicin and Dexamethasone

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