RESUMO
Objective: The aim of our study is to evaluate the effectiveness of intratympanic gentamicin injection (ITG) on vertigo control with reduced doses and its hearing effects. Materials and Method: The study was conducted at Otolaryngology Department of AORN “S.G. Moscati” between January 2005 and January 2015 on 72 patients with disabling unilateral Meniere’s disease. We use 0.2-0.3 mL of gentamicin sulfate at a concentration of 40mg/ml, injected into the affected ear through the posterior-inferior quadrant of the tympanic membrane. The procedure was carried out for three following days. Main outcome measures: vertigo control and hearing threshold changes after ITG treatment. Results: In 98.6% of the patients(n=71) the ITG produced the full remission of the vertiginous symptoms. In 91.6% of cases(n=66) a single treatment (three consequent injections) was sufficient to control vertigo, in 5.5% of cases(n=4) two treatments were necessary to control vertigo and in 1.3% of patients(n=1) three treatments were necessary to control vertigo. In no case we have had hearing loss after ITG procedure. The pre-treatment pure tone average was 48db. The post-treatment pure tone average was 49.2db. This difference was no statistical difference. Conclusion: In this study we reported high vertigo control, long follow-up and no case of significant hearing worsening. We consider the three injections in the following three days with low doses of gentamicin a safe and valid treatment for Meniere’s disease.
RESUMO
BACKGROUND AND OBJECTIVES: Familial aminoglycoside-induced deafness has been described in a number of Chinese and Japanese pedigrees. Recently, the familial aminoglycoside-induced ototoxicity is proved to be associated with a mutation in mitochondrial (mt) 12S ribosomal RNA (rRNA) gene at nucleotide position 1555 in some families. In this study, we analyzed mt 12S rRNA gene to find out this particular mutation in Korean pedigrees who had a family history of hearing loss. MATERIALS AND METHODS: Peripherial blood was obtained from 91 individuals of 30 families, and total genomic DNA (gDNA) was extracted. A fragment of DNA including a part of mt 12S rRNA gene was amplified by polymerase chain reaction (PCR). The PCR products were analyzed by restriction digestion with Bsm A1 and DNA sequencing. RESULTS: We found one family of mtDNA A1555G. Six family members had mutant genotype and three of them showed severe sensorineural hearing loss or deafness. The mutation was homoplasmic in all affected family members, and the genotype revealed maternal transmission. CONCLUSION: We found the first case of familial hearing loss genetically proved to be associated with the mt 12S rRNA gene mutation, in Korea. Because it is possible that an individual with this mutation shows a progressive sensorineural hearing loss, a screening of mtDNA A1555G mutation for the familial members who have a maternal inheritant hearing loss might be necessary.