Scientific publications

Treatment of Meniere Disease with on-demand intratympanic gentamicin injections

Manrique-Huarte R [SP], Guillén-Grima F [SP], Perez-Fernandez N.
Departments of *Otorhinolaryngology, and †Preventive Medicine, Clínica Universidad de Navarra, University Hospital and Medical School, University of Navarra, Navarra, Spain

Magazine: Otology & Neurolotogy

Date: Feb 10, 2011

Preventive Medicine [SP] Otorhinolaryngology

OBJECTIVE
To determine the clinical response to intratympanic administration of gentamicin in patients with Ménière's disease and to ascertain whether the pure-tone average, caloric test, or disease duration might predict clinical control.

DESIGN
Prospective study. Patients were followed for at least 2 years after the first injection (mean follow up time, 39 mo), and a Kaplan-Meier analysis was used to determine the survival curve that best explains the response to treatment.

SETTING

Tertiary center, University hospital.

PATIENTS
Individuals diagnosed with unilateral Ménière's disease that did not respond to previous medical treatment and who had not previously undergone surgery. Of the initial 83 patients recruited, 9 were lost during the follow-up, and thus, 74 subjects were included in the study.

INTERVENTION
In the consultant's surgery, a myringotomy was performed with topic administration of phenol before the intratympanic administration of 2 to 3 ml of gentamicin (26.7 mg/ml). Further injections were administered if vertigo was not controlled and recurred.

MAIN OUTCOME MEASURES
Absence of vertigo and the need for subsequent injections as measured in using a Kaplan-Meier time-to-event process. To test predictive variables, the log-rank test was used.

RESULTS
Complete control of vertigo was obtained with a single injection of gentamicin in 53% of the patients. Subsequent injections offered a 50% chance of obtaining complete control. Better results were obtained in patients in whom disease duration was less than 3 years.

CONCLUSION
On-demand administration of intratympanic gentamicin provides an alternative treatment for medically refractory Ménière's disease. Moreover, the Kaplan-Meier analysis was useful to analyze recurrent manifestations, such as vertigo attacks in Ménière's disease.

CITATION  Otol Neurotol. 2011 Feb 10

you maybe interested

WHAT TECHNOLOGY
DO WE USE?

The Clínica is the greater private hospital with technological equipment of Spain, all in a single center.

Imagen de un PET, tecnología de vanguardia en la Clínica Universidad de Navarra

OUR
PROFESSIONALS

The professionals of the Clínica perform continuous research and training, always to the benefit of the patient.

Imagen profesionales de la Clínica Universidad de Navarra

WHY CHOOSE
THE CLINICA?

Learn why we are different from other healthcare centers. Quality, speed, comfort and results.

Imagen del edificio de la Clínica Universidad de Navarra