Effect of Intratympanic Gentamicin Therapy in Meniere’s disease

Suresh, V (2011) Effect of Intratympanic Gentamicin Therapy in Meniere’s disease. Masters thesis, Madras Medical College, Chennai.

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Abstract

INTRODUCTION: Prosper Meniere was the first person to describe the symptoms of Meniere’s disease in1861. He proposed that the pathologic locus was in the labyrinth. Meniere’s disease is a disorder of the inner ear. The symptom complex of Meniere’s disease consists of spontaneous, episodic attacks of vertigo, fluctuating sensorineural hearing loss, tinnitus, sensation of aural fullness. Meniere’s disease is often idiopathic and it can be caused by distention of endolymphatic space. Incidence of Meniere’s disease is more common in patient attending neuro otology clinic with dizziness. This disease has peak incidence in working age group between 30 to 60 years. Gentamicin is an amino glycoside antibiotic that is preferentially toxic to the dark cell and hair cells of the vestibular labyrinth. It is less cochlea toxic when compared with other amino glycoside. Now the gentamicin perfusion has emerged as a predominant therapy for incapacitating the vertigo of Meniere’s disease. This study has been done to find out the effect of intratympanic gentamicin therapy in Meniere’s disease. AIMS OF STUDY: 1. To diagnose the patients with very definite and definite Meniere’s disease using electrocochleography. 2. To study the effectiveness of intratympanic gentamicin therapy in vertigo control. 3. To compare the intratympanic gentamicin therapy and oral therapy in Meniere’s disease. 4. To study the post intratympanic gentamicin therapy electrocochleographic changes. 5. To study the changes in hearing level, pre and post intratympanic gentamicin therapy. MATERIALS: This study was a prospective study. Institutional ethical committee clearance was obtained for the study. During the study period Jan 2010 to Nov 2010, the patients attending the outpatient department of the Upgraded Institute of Otorhinolaryngology, Madras Medical College & Government General Hospital, and Chennai were screened for Meniere’s disease. These patients were explained about the study. Those who have given consent were included in the study as per inclusion and exclusion criteria. Inclusion Criteria: People attending neuro – otologic clinic were classified into Very definite and Definite Meniere’s disease according to AAO HNS classification. AAO-HNS CLASSIFICATION: VERY DEFINITE MERIERE’S DISEASE • The patient has had at least two attacks of sudden vertigo has lasted more than 20 minutes but less than a day along with Deafness, Tinnitus, Aural fullness, Glycerol dehydration test positive, EcochG positive. DEFINITE MENIERE’S DISEASE; • Episodic vertigo, Deafness, Tinnitus, Aural fullness, Positive glycerol positive test, Typical EcochG finding not present. Both male and female, age > 15 years. Exclusion Criteria: People with previous ear disease like CSOM, congenital malformation, People with previous ear surgeries, syphilis, intracranial tumour, People on ototoxic drugs, head injury, any other major exanthematous illness, People with positive family history of HOH. Sample Size: 50. Control Group: The patients were attending neuro-otologic clinic with symptoms of Meniere’s disease. The patient is treated with oral betahistine. CONCLUSION: In this study 60% of patients were diagnosed with very definite Meniere’s disease and 40% of patients were diagnosed definite Meniere’s disease using ECochG. In this study 60% of patients showed improvements of vertigo control with intratympanic gentamicin therapy, while in control group only 30% of patients showed improvements. My study shows that intatympanic gentamicin therapy is more effective in controlling vertigo in Meniere’s disease patients. Post intra tympanic gentamicin therapy ECochG was significantly improved. In this study 10% of patients showed worsening of hearing level with intratympanic gentamicin therapy, while in 6.7% of patients showed worsening of hearing with oral therapy.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Intratympanic Gentamicin Therapy, Meniere’s disease.
Subjects: MEDICAL > Otolaryngology
Depositing User: Devi S
Date Deposited: 15 Mar 2020 13:58
Last Modified: 15 Mar 2020 13:58
URI: http://repository-tnmgrmu.ac.in/id/eprint/12280

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