Low dose transtympanic gentamicin treatment for intractable Meniere's disease: a prospective study.

OBJECTIVE: To evaluate the effectiveness of low dose transtympanic gentamicin treatment in Meniere's disease. MATERIAL AND METHOD: Prospective study of 20 disable Meniere's patients in Ramathibodi Hospital who received transtympanic gentamicin treatment for Meniere's disease by fixed dose regimen of 12 injections during a period of 4 days. The study took place from March 1999 to December 2004. The hearing and equilibrium guidelines for reporting treatment results in Meniere's disease of the American Academy of Otolaryngology and Head & Neck Surgery (1995) were used. The outcomes of treatment were evaluated at the 6th month. The multivariate repeated measures ANOVA was used for statistical comparisons. RESULTS: During the 5-year period, there were 20 patients, 9 men, and 11 women. The six-month outcomes of vertigo control, the functional level scale and tinnitus score were significantly improved by the treatment. Whereas, the mid frequency pure tone threshold average and the speech discrimination score were not significantly affected. CONCLUSION: Fixed low dose transtympanic gentamicin treatment was found to be an effective treatment option for patients with disabling or intractable Meniere's disease, with a low incidence of hearing deterioration. The use of this method appears to be practical and has been set as the standard protocol replacing the vestibular surgery in Ramathibodi Hospital.

Transtympanic gentamicin treatment in Meniere's disease: a preliminary report.

OBJECTIVE: To evaluate the effectiveness of transtympanic gentamicin treatment in Meniere's disease. MATERIAL AND METHOD: The present study is a prospective study of 8 patients in Ramathibodi Hospital who had transtympanic gentamicin treatment of Meniere's disease by fixed dose regimen of 12 injections during a period of 4 days. The committee on hearing and equilibrium guidelines for reporting treatment results in Meniere's disease of the American Academy of Otolaryngology and Head & Neck Surgery (1995) were used. Paired t-test or Wilcoxon Signed Ranks Test was used for statistical comparisons. RESULTS: Among 8 patients, there were 2 males and 6 females. All patients (100%) had either complete (37.5%) or substantial (62.5%) control of vertigo. Disability was also improved in all of the subjects (100%). Tinnitus was improved in 62.5%. Their tinnitus score and functional level scale were much improved with statistical significance (p = 0.001, p < 0.005, respectively). Hearing was unchanged in 87.5% and slightly worse in 12.5%. This was not significant. CONCLUSION: Transtympanic gentamicin treatment was found to be an effective treatment option for patients with disabling or intractable Meniere's disease, with a low incidence of hearing loss. The use of this method appears to be practical and may replace the vestibular surgery.

Pediatric cochlear implantation: experience in Thai patients.

OBJECTIVE: This study was to evaluate the result of cochlear implantation in Thai pediatric patients from 1999-2003. DESIGN: A prospective, open-labeled study. SETTING: University teaching hospital. MATERIAL AND METHOD: Long term surgical and audiologic results comparison after cochlear implantation in 2 cases with Mondini anomality, 7 normal cochlea cases and a case of post meningitis post lingual child. MAIN OUTCOME MEASURES: Speech perception tests battery. RESULTS: Among 10 children, 8 were implanted with Nucleus 22/24; the other two were implanted with Med-el device system. The pre-operated cochlea in 2 cases showed Mondini deformity; both had gushers during the operation with a good outcome. The other 8 cases had normal cochlea although one was deaf from bacterial meningitis. There were 3 re-implantations. Speech production and perception was improved faster in the two children implanted with Med-el than those implanted with Nucleus devices. CONCLUSION: Cochlear implantation in Mondini cases can be successful in speech production and perception. Speech perception ability depended on the age of implantation and preoperative rehabilitation.