A retrospective comparison of intratympanic dexamethasone with gentamicin in meniere's disease – A single-institutional study

Abstract

Background: Intratympanic gentamycin or steroids are used to treat refractory Meniere's disease with variable results. The aim of this study is to analyse and compare the vertigo control and hearing outcomes of intratympanic (IT) Dexamethasone and Gentamycin in patients with definite Meniere's disease (MD). Subjects and Methods: A retrospective cohort study in a tertiary care hospital. Patient's age, sex, laterality of disease, vertigo control rates after 6 and 12 months of treatment, mean doses of IT injections given, pre- and post-therapy Pure tone audiogram (PTA) of Bone conduction levels and complications were recorded. Results: 31 patients who met the study criteria were included in the study. 18 received IT dexamethasone (Group 1) and 13 (Group 2) received IT gentamycin injections. The mean number of IT injections given irrespective of outcomes were 2.44 ± .705 and 2.08 ± 0.760 respectively (P= 0.176). Though the pre-treatment PTA was comparable in both the groups (41.76 ± 7.29 dB vs 45.66 ± 7.59 dB), Group A had better hearing preservation than group B (40.47 ± 7.79 vs 48.06 ± 8.56 dB) (P= 0.000). The vertigo control rates at the end of 6 and 12 months were 61.1% vs 84.6% & 81.25 vs 77.7% respectively (P= 0.363 & 0.093). Conclusion: Intratympanic Dexamethasone is an effective treatment option in patients with MD. Though the mean number of injections required were higher than Gentamycin, the difference was not statistically significant.