Intratympanic Gentamicin Injection Research Articles

Intratympanic gentamicin therapy for vertigo in nonserviceable ears

Purpose: Intratympanic ototoxic agents have become a widely accepted means of managing vertigo in patients with Meniere's disease while preserving residual hearing. We investigated expanding the indications for intratympanic gentamicin to include control of vertigo in patients without serviceable hearing in the involved ear caused by a variety of end-organ pathologies. Materials and Methods: We present a retrospective series of 6 patients suffering from vertigo caused by end-organ disease, in an ear without serviceable hearing. Two patients suffered from delayed endolymphatic hydrops, 3 from Meniere's disease, and 1 from poststapedectomy vertigo. These patients chose unilateral vestibular ablation with serial intratympanic gentamicin injection rather than labyrinthectomy for a variety of reasons. Conventional electronystagmography (ENG) testing and audiometry were completed on all patients. The ENG testing included bithermal calorics and rotational testing. All patients had a magnetic resonance image with gadolinium to exclude retrocochlear or central pathology. Rotational testing was repeated before each injection and at the conclusion of therapy to assess changes in the peripheral vestibular response. The patients' subjective response to therapy was followed. Results: Follow-up has been 10 to 69 months with successful control of vertigo in all patients. Conclusions: Intratympanic gentamicin therapy offers a minimally invasive, ambulatory, low morbidity, cost-effective means of managing vertigo in patients with nonserviceable hearing. (Am J Otolaryngol 2001;22:111-115. Copyright © 2001 by W.B. Saunders Company)

Update on intratympanic gentamicin for Meniere's disease.

To review the literature relating to intratympanic gentamicin injection therapy for Meniere's disease to detect consistencies and differences that might suggest optimal technique. Retrospective literature review. Eighteen papers from the literature regarding clinical experience with intratympanic gentamicin injections for treatment of Meniere's disease were reviewed and tabulated. All papers reported high success rates in treating episodic vertigo of Meniere's disease, but technique, dose, duration, and treatment philosophy varied considerably. Hearing loss was typically reported in about 30% of patients. No single technique of gentamicin injection has a significant medical advantage over the others. Until controlled studies indicate otherwise, nonmedical needs such as convenience and safety may be considered when choosing a technique.

Neurodegenerative changes in the guinea pig brainstem after intratympanic injection of gentamicin

Gentamicin (4%) was injected intratympanically into the middle ear of guinea pigs and the effects on the brainstem evaluated 28 days later by immunohistochemistry with an antibody against glial fibrillary acidic protein to detect astrocytes, and by cytochrome oxidase staining to detect metabolic activity. Astrocytes were observed in the cochlear nucleus indicating the possible presence of anterograde degeneration. Deficiencies in the intensity of cytochrome oxidase staining up to the level of the superior olivary complex indicated the presence of abnormal metabolic activity. Both of these observations support the conclusion that a single intratympanic injection of gentamicin may lead to neuronal degeneration along the central auditory pathway.

The Treatment Of Hearing Loss In Meniere’s Disease

A review of the recent literature concerning hearing loss and Meniere's disease is presented. A compilation of the change in hearing resulting from endolymphatic sac surgery, vestibular nerve section, and intratympanic gentamicin injection and a summary of the results of pharmacologic interventions is tabulated for 1986 to 1996. Although vertigo control is variable with the above treatment strategies, hearing loss does not appear altered by any of them when compared with the natural history of hearing loss associated with Meniere's disease. Further investigation is necessary to understand the underlying cause of hearing loss in Meniere's disease and to eventually control its progression.

Intratympanic gentamicin injection and inner ear kinetics in the chinchilla

Otolaryngology–Head and Neck SurgeryVolume 117, Issue 2 p. P92-P92 Original Article Intratympanic Gentamicin Injection and Inner Ear Kinetics in the Chinchilla Jenifer Henderson MD, LT MC USNR, Jenifer Henderson MD, LT MC USNR (presenter) San Diego, Calif.Search for more papers by this authorMichael E. Hoffer MD, LCDR MC USNR, Michael E. Hoffer MD, LCDR MC USNR San Diego, Calif.Search for more papers by this authorBen J. Balough MD, LCDR MC USNR, Ben J. Balough MD, LCDR MC USNR San Diego, Calif.Search for more papers by this authorDerin Wester PhD, Derin Wester PhD San Diego, Calif.Search for more papers by this authorMichael J. O'Leary MD, Michael J. O'Leary MD San Diego, Calif.Search for more papers by this author Jenifer Henderson MD, LT MC USNR, Jenifer Henderson MD, LT MC USNR (presenter) San Diego, Calif.Search for more papers by this authorMichael E. Hoffer MD, LCDR MC USNR, Michael E. Hoffer MD, LCDR MC USNR San Diego, Calif.Search for more papers by this authorBen J. Balough MD, LCDR MC USNR, Ben J. Balough MD, LCDR MC USNR San Diego, Calif.Search for more papers by this authorDerin Wester PhD, Derin Wester PhD San Diego, Calif.Search for more papers by this authorMichael J. O'Leary MD, Michael J. O'Leary MD San Diego, Calif.Search for more papers by this author First published: 01 August 1997 https://doi.org/10.1016/S0194-59989780130-1Read the full textAboutPDF ToolsExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume117, Issue2August 1997Pages P92-P92 RelatedInformation

小児期に発症し，長期間観察しえたメニエール病の一例

Meniere's disease in children comprises only a small percentage of all patients of Meniere's disease, and is known to be quite rare. A juvenile patient who has been followed for more than 8 years is reported in this paper.This 18-year-old female patient was brought to our department when she was 9 years old with a chief complaint of right-side hearing loss. She had a history of paroxysmal rotatory vertigo with accompanying headache twice per year since she was 5 years old. Right-side hearing loss and tinnitus had been noted since she was 9 years old. The hearing loss and the tinnitus were aggravated during the attacks of vertigo. Physical examinations revealed low-tone perceptive hearing loss of about 43 dB on the right ear. Caloric test revealed right canal paresis. Glycerol test results were positive. Since the vertigo attacks were episodic, and the equal-loudness contours on three-dimensional audiogram showed that aggravated hearing loss fluctuated despite medication, the patient received right-side intratympanic gentamicin injection when she was 16 years old. To date, vertigo has subsided for more than 2 years since the intratympanic injection.

Intratympanic Injection of Gentamicin for the Treatment of Delayed Endolymphatic Hydrops

In three patients with ipsilateral delayed endolymphatic hydrops (DEH), ototoxic gentamicin sulfate was injected through the tympanic membrane for the ablative treatment of frequent attacks of vertigo. Two patients received six injections and one patient received two. Treatment produced complete control of vertigo attacks in one patient who received six injections, and substantial control in the other two patients. The present results showed that there was a delayed onset of the ototoxic effect of gentamicin in the treatment of ipsilateral DEH.