0000000000199842
AUTHOR
Gert Lange
Intratympanic gentamicin treatment after endolymphatic sac surgery.
Interval treatment with up to three intratympanic gentamicin injections once weekly effectively controlled vertigo while preserving hearing in patients with Ménière's disease and recurrent or resistant vertigo after saccotomy.Recurrent or resistant incapacitating vertigo may occur after endolymphatic sac surgery (saccotomy) in patients with Ménière's disease. In these patients, revision saccotomy, vestibular nerve section or labyrinthectomy are the established treatment options. We advocate a once-weekly application of intratympanic gentamicin (12 mg) as an effective alternative in this group of patients.Five patients (age range 39-65 years) with definite Ménière's disease according to the …
Intratympanale Intervalltherapie des Morbus Meni�re mit Gentamicin unter Erhalt der Kochleafunktion
Patienten und Methode Zwischen 1997 und 2000 haben wir 57 Patienten intratympanal einseitig mit Gentamicininjektionen (jeweils 0,3 ml = 12 mg) therapiert. Eine Therapieserie bestand maximal aus je einer Injektion an Tag 1, 8 und 15. Intratympanal injiziertes Gentamicin akkumuliert langsam (Durchschnitt unseres Krankenguts: 4,6 Tage) im Innenohr. Die Intervalltherapie vermeidet uberhohte Gentamicinkonzentrationen. Sobald Zeichen einer Innenohrreaktion auftreten (Nystagmus, Unsicherheit, Schwindel), hat die Therapie gewirkt und darf keinesfalls weitergefuhrt werden.
Long-Term Results after Interval Therapy with Intratympanic Gentamicin for Meni??re???s Disease
Objectives The new single-shot and interval treatment for Meniere's disease with gentamicin was designed to avoid cochlear damage during treatment with gentamicin. Methods To date, 90 patients were treated with the single-shot or interval gentamicin therapy. Fifty-seven cases of Meniere's disease were followed up prospectively between 2 and 4 years. During one treatment series, a maximum of three intratympanic gentamicin injections within 15 days were applied, each consisting of 0.3 mL (12 mg) of gentamicin (days 1, 8, and 15). Thirty of these 57 patients (53%) needed only one injection to be controlled (single-shot treatment). Results Vertigo attacks were completely controlled in 95% and p…