Intratympanic gentamicin therapy for control of vertigo in unilateral Menière's disease: a prospective, double-blind, randomized, placebo-controlled trial

Postema, R.; Kingma, C. M.; Wit, H. P.; Albers, F. W. J.; Laan, Bernard F. A. M. van der

doi:10.1080/00016480701762458

Cited by 84 publications

(100 citation statements)

References 6 publications

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“…Gentamicine is a destructive treatment aiming for a partial ablation of vestibular functions. It inherently carries a risk of hearing deterioration as a side effect [52]. A therapy with a proven beneficial effect on the natural course of the disease is still lacking.…”

Section: Discussionmentioning

confidence: 99%

MR volumetric assessment of endolymphatic hydrops

Gürkov¹,

Berman²,

Dietrich³

et al. 2014

Eur Radiol

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• Endolymphatic hydrops is the pathological hallmark of Menière's disease. • Endolymphatic hydrops can be visualized by locally enhanced ultra-high-resolution MR imaging. • Computer-aided image processing enables quantification of endolymphatic hydrops. • Endolymphatic hydrops correlates with hearing loss in patients with Menière's disease. • Therapeutic trials in Menière's disease can be monitored with this quantitative approach.

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Section: Discussionmentioning

confidence: 99%

MR volumetric assessment of endolymphatic hydrops

Gürkov¹,

Berman²,

Dietrich³

et al. 2014

Eur Radiol

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“…Improvements in control of vertigo was also identified in two other smaller prospective double blind randomised placebo controlled trials (13,14). There are no studies that investigate the efficacy of steroid therapy alone via any route versus placebo for the treatment of MD symptoms.…”

Section: Steroidsmentioning

confidence: 92%

Meniere’s disease: an evidence based approach to assessment and management

Syed

Aldren

2012

International Journal of Clinical Practice

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Menière's disease (MD) is frequently over-diagnosed in both primary and secondary care. This is unfortunate given the significant medical and social implications of such a diagnosis. Difficulties may arise in differentiating the patient with true MD from those individuals with less clearly defined disorders of cochleo-vestibular function. In this review, we suggest a practical evidence based approach to assessment and management of the patient with MD.

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“…Over the past decade, IT gentamicin injection has gained popularity because of its advantages over surgical ablation in convenience, efficacy, and safety. However, many of the outcomes data are from small intervention studies (9Y11,13Y15) with fewer than 50 participants, and it is difficult to conduct randomized controlled trials among patients with intractable MD (17,18). Because the validity of data from a single study often is questioned, there has been no consensus on the most appropriate treatment protocol.…”

Section: Discussionmentioning

confidence: 97%

Outcome of Intratympanic Gentamicin Injection for Ménière Disease

Huon¹,

Fang²,

Wang³

2011

Otolaryngol.--head neck surg.

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window can be used to control symptoms. It provides an alternative to the plugging and resurfacing techniques. This procedure is simple to perform, is reversible, and can be undertaken as a day case. Otology/NeurotologyOutcome of intratympanic Gentamicin injection for Ménière Disease Leh-Kiong Huon (presenter); Te-Yung Fang; Pa-Chun Wang, MD, MScObjective: Intratympanic genemicin (ITG) is an option for the treatment of intractable Ménière disease (MD). The aim of this study is to investigate the outcomes of ITG for MD using evidence-based methodology. Method:The MedLine database (1985~2010) was searched for original articles (level I or II in evidence strength) published in peer-reviewed journals concerning ITG for MD. Data extracted from these articles were reviewed and analyzed using meta-analysis technology.Results: A total of 15 articles were clitically appraised; 2 prospective, double-blinded randomized control trials (level I) and 13 prospective noncontrolled clinical trials (level II) were indentified. The pooled vertigo control rates (American Academy of Otolaryngology Head and Neck Surgery guidelines for Ménière disease) from 15 studies are: overall control rate 78% (class A, 95% CI 0.67-0.85), substantial control rate 56 % to 98% (class A and B, 95% CI 0.25-1.0) following ITG treatment (P = .0001). Hearing is worse in 0% to 61% (95% CI 0.02-0.83) after gentamicin treatment, which was neither clinically nor statistically significant (P = 1.000). Conclusion:The critical literature and meta-analyses show that ITG can control vertigo for MD patients with limited injury to hearing. Quality of research has improved remarkably over the years. However, a large scale, randomized controlled trial is warranted to confirm the predicting factors for the true effectiveness of ITG in treating MD. Otology/NeurotologyOutpatient labyrinthectomy Kevin X. McKennan, MD (presenter) Objective: With newly available anti-nausea/vertigo medications, selected patients can undergo transmastoid labyrinthectomy as an outpatient procedure.Method: Ten patients pretreated with a cocktail of Emend/ Transderm Scop Patch/Decadron underwent a transmastoid labyrinthectomy. These patients were all treated as outpatients. These 10 patients will be compared with 10 similar patients hospitalized after surgery. Method: A retrospective chart review was performed from January 1, 1999 until January 1, 2011, to identify patients under 17 years old who underwent a stapedectomy. Age, gender, pre-and postoperative audiograms, intraoperative findings including cause of stapes fixation, type of prosthesis used, and complications were recorded.Results: Eighteen children were identified who had undergone a stapedectomy. The cause of fixation included otosclerosis (n = 7), congenital footplate fixation (n = 9), and unknown cause (n = 2). The overall mean preoperative air-bone gap (ABG) was 35.7 dB (±10.4), compared with a postoperative mean ABG of 15.1 (±15.6) (P < 000.1). The mean postoperative ABG of 14.5 (±5.3) in the congenital footplate fixation gr...

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Intratympanic gentamicin therapy for control of vertigo in unilateral Menière's disease: a prospective, double-blind, randomized, placebo-controlled trial

Abstract: Gentamicin treatment resulted in a significant reduction of the score for vertigo complaints and the score for perceived aural fullness. A small increase in hearing loss (average 8 dB) was measured in the gentamicin group.

Cited by 84 publications

References 6 publications

MR volumetric assessment of endolymphatic hydrops

MR volumetric assessment of endolymphatic hydrops

Meniere’s disease: an evidence based approach to assessment and management

Outcome of Intratympanic Gentamicin Injection for Ménière Disease

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