Evaluation of the effect of intratympanic injection of gentamicin for resistant cases of Meniere’s disease on hearing and vestibular functions

• Published in: The Egyptian journal of otolaryngology 2015-04, Vol.31 (2), p.135-139
• Main Authors: Baki, Fatthi, Asal, Samir, Shewel, Yasser, Galal, Ahmed
• Format: Article
• Language: English
• Subjects: Medicine & Public Health; Original Article; Surgery
• ISSN: 1012-5574; 2090-8539
• DOI: 10.4103/1012-5574.156099

En Objectives This study was performed to investigate the effect of a single minimal dose of intratympanic injection (IT) gentamicin on hearing and otolithic function, mainly on the utricle and saccule independently. Patients and methods Our study was performed on 10 patients with definite Meniere’s disease diagnosed according to AAO-HNS criteria and who had been showing resistance to medical treatment for more than 6 months with persistent vertigo affecting their lifestyle. IT of gentamicin was given under local anesthesia through direct perfusion in a single dose of 12 mg (0.3 ml of 40 mg/ml) unilaterally on the lesion side. Preinjection evaluation included history, otoscopy, formal pure tone audiometry (PTA), and tympanometry. In addition, cervical vestibular-evoked myogenic potential (cVEMP) and oVEMP were tested. One month after injection, PTA and both VEMP tests were again carried out. Data before and after injection were analyzed and correlated. Results No overall significant effect on hearing was found. IT gentamicin had significant effect on cVEMPs with 100% abolition, as well as a statistically significant effect on oVEMP with 70% abolition and distortion of the remaining 30%. In these remaining 30% latencies and amplitudes, there was no significant difference in values before and after injection. Conclusion A 12 mg single dose of gentamicin can abolish otolithic function without affecting hearing.