Outcome and quality of life after intratympanic therapy for control of Meniere's disease

ABSTRACT

Meniere's disease [MD] is characterized by spontaneous attacks of vertigo, fluctuating sensorinewal hearing loss, aural fullness, and tinnitus. Many therapeutic options exist for the management of patients with Meniere's disease, nevertheless, there is no proven cure to date. Over the past decade, intratympanic administration of gentamycin or corticosteroid has become a major treatment modality for intractable MD. The study aimed at identifying the efficacy of intratympanic treatment, from the author's view point, whether gentamicin or corticosteroids and its effect on the quality of life. Prospective investigational protocol. 45 MD patients, divided into 3 groups of 15 patients each, treated with gentamicin-[group a], corticosteroids [group b] and saline [group c]. ENT Outpatient clinic, at Mansoura University Hospitals. All the patients were subjected to thorough history taking, otoscopic examination and full audiovestibular evaluation. Administration of activities of daily living scale [ADL] questionnaire to assess the self perceived disablement immediately before injection, 1, 6 and 12 months post injection. Repeated injections for complete control of vertigo in groups A and B were almost identical in comparison to placebo group [c]. Nevertheless, hearing sensitivity and speech discrimination scores were markedly improved in the corticosteroids [B] group, in contrast to the further deterioration that took place in the gentamicin [A] group. ADL significantly improved post treatment in both a and b groups only. Intratympanic gentamicin tltration offers a minimally invastive, cost-effective, low morbidity means of managing vertigo. Intratympanic injection of corticosteroids results in control of vertigo with improved hearing sensitivity and better speech discrimination scores than gentamicin