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Transtympanic gentamicin treatment using Silverstein MicroWick in Ménière's disease patients: long term outcome

Published online by Cambridge University Press:  04 June 2008

R Suryanarayanan ,
V R Srinivasan  and
G O'Sullivan
R Suryanarayanan*
Affiliation:
Department of Otolaryngology, Arrowe Park Hospital, Wirral, Merseyside, UK
V R Srinivasan
Affiliation:
Department of Otolaryngology, Arrowe Park Hospital, Wirral, Merseyside, UK
G O'Sullivan
Affiliation:
Department of Otolaryngology, Arrowe Park Hospital, Wirral, Merseyside, UK
*
Address for correspondence: Mr R Suryanarayanan, ENT Department, Arrowe Park Hospital, Arrowe Park Road, Upton, Wirral, CH49 5PE. E-mail: [email protected]
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Abstract

Objective:

To assess the long term outcome of gentamicin inner-ear perfusion using the Silverstein MicroWick™ in the treatment of Ménière's disease.

Study design:

Retrospective questionnaire survey of patients and review of medical records.

Setting:

A district general hospital.

Participants:

All 15 patients who completed a minimum follow up of at least 24 months were included.

Main outcome measures:

Subjective symptoms, change in hearing thresholds and Glasgow benefit inventory scores.

Results:

Based on the American Association of Otolaryngology-Head and Neck Surgery (1995) guidelines for reporting, 80 per cent of respondents obtained class A vertigo control and 20 per cent obtained class B control. Respondents' functional level improved from pre-operative levels of between three and six to post-operative levels of between one and three. Three respondents had pre-operative ‘dead ears’ and one developed the condition post-operatively. Hearing deteriorated further in three respondents, improved in two and remained unchanged in the rest. Respondents with class A control demonstrated improved quality of life, with a mean Glasgow benefit inventory total score of +34.

Conclusion:

Transtympanic gentamicin therapy via the Silverstein MicroWick results in good vertigo control. Patients should however be made fully aware of the risk of hearing deterioration.

Keywords

VertigoMeniere's DiseaseGentamicinMiddle Ear
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 123 , Issue 1 , January 2009 , pp. 45 - 49
Copyright
Copyright © JLO (1984) Limited 2008

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Footnotes

Presented at the otology section of the Royal Society of Medicine, 2 March 2007, London, UK.

References

1 Pender, DJ. Gentamicin tympanoclysis: effects on the vestibular secretory cells. Am J Otolaryngol 1985;6:358–67CrossRefGoogle ScholarPubMed
2 Obholzer, RJ, Wareing, MJ. Intratympanic gentamicin for Ménière's disease: a survey of current UK practice. J Laryngol Otol 2003;117:459–61Google ScholarPubMed
3 Suryanarayanan, R, Cook, JA. Long term results of gentamicin inner ear perfusion in Ménière's disease. J Laryngol Otol 2004;118:489–95CrossRefGoogle ScholarPubMed
4 Silverstein, H. Use of a new device, the MicroWick, to deliver medication to the inner ear. Ear Nose Throat J 1999;78:595–600CrossRefGoogle ScholarPubMed
5 Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Meniere's disease. Otolaryngol Head Neck Surg 1995;113:181–5CrossRefGoogle Scholar
6 Silverstein, H, Durand, B, Jackson, LE, Conlon, WS, Rosenberg, SI. Use of the malleus handle as a landmark for localizing the round window membrane. Ear Nose Throat J 2001;80:444–8CrossRefGoogle ScholarPubMed
7 Robinson, K, Gatehouse, S, Browning, GG. Measuring patient benefit from otorhinolaryngological surgery and therapy. Ann Otol Rhinol Laryngol 1996;105:415–22CrossRefGoogle ScholarPubMed
8 Cohen-Kerem, R, Kisilevsky, V, Einarson, TR, Kozer, E, Koren, G, Rutka, JA. Intratympanic gentamicin for Meniere's disease: a meta-analysis. Laryngoscope 2004;114:2085–91CrossRefGoogle ScholarPubMed
9 Jackson, LE, Silverstein, H. Chemical perfusion of the inner ear. Otolaryngol Clin North Am 2002;35:639–53CrossRefGoogle ScholarPubMed
10 Hill, SL 3rd, Digges, EN, Silverstein, H. Long-term follow-up after gentamicin application via the Silverstein MicroWick in the treatment of Meniere's disease. Ear Nose Throat J 2006;85:494, 496, 498CrossRefGoogle ScholarPubMed
11 Hillman, TA, Chen, DA, Arriaga, MA. Vestibular nerve section versus intratympanic gentamicin for Meniere's disease. Laryngoscope 2004;114:216–22CrossRefGoogle ScholarPubMed
12 Colletti, V, Carner, M, Colletti, L. Auditory results after vestibular nerve section and intratympanic gentamicin for Meniere's disease. Otol Neurotol 2007;28:145–51CrossRefGoogle ScholarPubMed
13 Hoffer, ME, Kopke, RD, Weisskopf, P, Gottshall, K, Allen, K, Wester, D et al. Use of the round window microcatheter in the treatment of Meniere's disease. Laryngoscope 2001;111:2046–9CrossRefGoogle ScholarPubMed