Long-term Effects of a Single Intratympanic Gentamycin Injection on Ménière’s Disease

Abstract

Objectives:

Intratympanic gentamycin (ITGM) injection is a useful treatment option in medically intractable Ménière’s disease (MD). Single ITGM injection has been used to control vertigo with lower risk of sensorineural hearing loss (SNHL) than multiple injections. The aim of this study was to evaluate the long-term effects of single-shot ITGM with regard to the vertigo control rate and incidence of SNHL.

Methods:

We retrospectively reviewed a cohort of MD patients in Samsung Medical Center to screen those who were intractable to medical management and underwent a single ITGM procedure. All enrolled patients were followed up for more than 2 years. Treatment efficacy was evaluated by using the American Academy of Otolaryngology—Head and Neck Surgery (AAO-HNS) Committee on Hearing and Equilibrium guidelines. Hearing was assessed by pure tone audiometry (PTA) results at 3 months after procedure and at the final visits.

Results:

Thirty-five patients were enrolled for the analysis, among whom five patients (14.2%) were in stage 4, twenty-eight (80%) were stage 3, and two (5.8%) were stage 2. In the long-term results, vertigo attacks were controlled completely (class A) in 25 patients (71.4%), substantially (class B) in 7 cases (20%), and limitedly (class C) in 3 cases (8.6%). SNHL was observed in 3 patients (8.5%) at 3 months and 9 cases (25.8%) at long-term follow-up.

Conclusions:

Single-shot ITGM therapy showed satisfactory vertigo control rate (91%) in long-term follow up. SNHL was observed in 17% at short term visits, and had reached 25% in long term evaluation, probably due to disease progression.