Intratympanic treatment in Meniere's disease: the effect of gentamicin and dexamethasone on vertigo control and hearing

Yıl 2006, Cilt: 16 Sayı: 5, 193 - 199, 14.10.2006

Levent Naci Özlüoğlu Babür Akkuzu Osman Nuri Özgirgin

Öz

Objectives: We investigated the effect of intratym- panic gentamicin and dexamethasone treatments on the control of vertigo and hearing loss in patients with Meniere's disease.Patients and Methods: Forty-five patients with a diag- nosis of Meniere's disease according to the 1995 crite- ria of American Academy of Otorhinolaryngology Head and Neck Surgery were assigned to receive intratym- panic gentamicin 40 mg/ml, 0.7 mİ; n=24; 11 males, 13 females; mean age 46 years or dexamethasone 4 mg/ml, 0.7 mİ; n=21; 8 males, 13 females; mean age 50.4 years . The results were evaluated with respect to changes in vertigo and hearing symptoms.Results: İn the gentamicin group, vertigo symptoms were controlled in 22 patients 92% , deterioration in hearing was seen in only two patients 8% . İn the dex- amethasone group, nine patients had complete follovv- up. Of these, vertigo control was achieved in six patients 67% , none had vvorsened hearing, and one patient 5% had improved hearing. When improve- ment in hearing was defined as at least a 5 dB change, then five patients 24% benefited from treatment.Conclusion: Intratympanic treatment modalities in Meniere's disease are easy to perform, cheap, and effective. They are expected to have a more exten- sive use with higher success rates in the future.

Anahtar Kelimeler

Dexamethasone, gentamicins, hearing/drug effects, Meniere's disease, vertigo

Meniere hastalığında intratimpanik tedavi: Gentamisin ve deksametazonun vertigo kontrolü ve işitme üzerine etkisi

Öz

Amaç: Meniere hastalığı› tedavisinde güncel uygulamalar olan intratimpanik gentamisin ve deksametazon tedavisinin vertigo kontrolü işitme üzerine olan etkileri araştırıldı Hastalar ve Yöntemler: Amerikan Otorinolarengoloji Başlı Boyun Cerrahisi Akademisi’nin 1995 ölçütlerine göre Meniere hastalığı tanısı konan 24 hastaya 11 erkek, 13 kadın; ort. yaşlı 46 intratimpanik gentamisin 40 mg/ml, 0.7 ml , 21 hastaya 8 erkek, 13 kadın; ort. yafl 50.4 ise intratimpanik deksametazon 4 mg/ml, 0.7 ml uygulandı. Tedavinin vertigo ve işlitme semptomları üzerine etkisi değerlendirildi. Bulgular: Gentamisin grubunda 22 hastada %92 vertigo kontrolü sağlandı, yaln›zca iki hastada %8 iflitmede kötüleflme görüldü. Deksametazon grubunda, 21 hastan›n dokuzunun takipleri tamamland›. Bunlar›n altısında %67 vertigo kontrolü sağlanırken, işlitmesi kötüleşlen hasta olmadı, bir hastanın %5 işlitmesinde düzelme görüldü. işitmede düzelme en az 5 dB’lik değiflme olarak tan›mlandığında, bu grupta işlitmede düzelme görülen hasta sayısı befl %24 idi. Sonuç: Meniere hastalığı tedavisinde intratimpanik tedaviler, uygulaması kolay, ucuz ve etkili, aynı zamanda gelecekte daha genişl uygulama alanları ve daha yüksek başları oranları beklenen yöntemlerdir.

Anahtar Kelimeler

Deksametazon, gentamisin, iflitme/ilaçetkisi, Meniere hastalığı, vertigo

Kaynakça

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