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Intratympanic Therapies in Ménière Disease: Evaluation of Outcomes and Early Vertigo Control.

Publication ,  Journal Article
Naples, JG; Henry, L; Brant, JA; Eliades, SJ; Ruckenstein, MJ
Published in: Laryngoscope
January 2019

OBJECTIVE: To evaluate outcomes of intratympanic (IT) dexamethasone and gentamicin in Ménière Disease (MD). METHODS: Charts of adult patients with unilateral definite MD receiving IT gentamicin or dexamethasone from 2005 to 2017 were retrospectively reviewed. All patients had at least 6 months follow-up. Failure in each group was defined as the need for more aggressive therapy. Prior to 2011, all patient received IT gentamicin, administered as primary therapy after failure of conservative treatment measures. Gentamicin was administered every 2 weeks, up to three injections, until vertigo control was achieved. Beginning in 2011, the treatment protocol shifted to IT dexamethasone as initial treatment, with gentamicin used for dexamethasone failures. Dexamethasone was administered weekly for up to three injections. Treatments could be repeated if symptoms recurred. RESULTS: Thirty-three patients received IT dexamethasone, and 70 patients received IT gentamicin. Dexamethasone patients received a mean of 3.3 injections compared to 2.7 in the gentamicin group (P = 0.011). There were 12 (38%) failures in the dexamethasone group and only seven (10%) gentamicin failures (P = 0.025). No patients failed both treatments. The mean time to failure in the dexamethasone group was 5 months, whereas in the gentamicin group it was 27 months. Change in pure tone audiometry from baseline was not different between treatment groups (P = 0.30). CONCLUSION: Subjects receiving IT gentamicin required fewer injections and had a significantly longer time to failure than IT dexamethasone. Audiometric outcomes were similar between the groups. The use of IT gentamicin as initial therapy for early and long-term control of MD is safe and effective. LEVEL OF EVIDENCE: 3 Laryngoscope, 129:216-221, 2019.

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Published In

Laryngoscope

DOI

EISSN

1531-4995

Publication Date

January 2019

Volume

129

Issue

1

Start / End Page

216 / 221

Location

United States

Related Subject Headings

  • Treatment Failure
  • Retrospective Studies
  • Protein Synthesis Inhibitors
  • Otorhinolaryngology
  • Meniere Disease
  • Male
  • Kaplan-Meier Estimate
  • Injection, Intratympanic
  • Humans
  • Glucocorticoids
 

Citation

APA
Chicago
ICMJE
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Naples, J. G., Henry, L., Brant, J. A., Eliades, S. J., & Ruckenstein, M. J. (2019). Intratympanic Therapies in Ménière Disease: Evaluation of Outcomes and Early Vertigo Control. Laryngoscope, 129(1), 216–221. https://doi.org/10.1002/lary.27392
Naples, James G., Laura Henry, Jason A. Brant, Steven J. Eliades, and Michael J. Ruckenstein. “Intratympanic Therapies in Ménière Disease: Evaluation of Outcomes and Early Vertigo Control.Laryngoscope 129, no. 1 (January 2019): 216–21. https://doi.org/10.1002/lary.27392.
Naples JG, Henry L, Brant JA, Eliades SJ, Ruckenstein MJ. Intratympanic Therapies in Ménière Disease: Evaluation of Outcomes and Early Vertigo Control. Laryngoscope. 2019 Jan;129(1):216–21.
Naples, James G., et al. “Intratympanic Therapies in Ménière Disease: Evaluation of Outcomes and Early Vertigo Control.Laryngoscope, vol. 129, no. 1, Jan. 2019, pp. 216–21. Pubmed, doi:10.1002/lary.27392.
Naples JG, Henry L, Brant JA, Eliades SJ, Ruckenstein MJ. Intratympanic Therapies in Ménière Disease: Evaluation of Outcomes and Early Vertigo Control. Laryngoscope. 2019 Jan;129(1):216–221.
Journal cover image

Published In

Laryngoscope

DOI

EISSN

1531-4995

Publication Date

January 2019

Volume

129

Issue

1

Start / End Page

216 / 221

Location

United States

Related Subject Headings

  • Treatment Failure
  • Retrospective Studies
  • Protein Synthesis Inhibitors
  • Otorhinolaryngology
  • Meniere Disease
  • Male
  • Kaplan-Meier Estimate
  • Injection, Intratympanic
  • Humans
  • Glucocorticoids