Streptomycin Perfusion through the Round Window in Meniere's Disease / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: Many local application methods have been developed for preventing vertigo attacks while preserving hearing loss. Among them, ototoxicity of aminoglycosides has been used for the treatment of Meniere's disease. The etiology and pathophysiology of Meniere's disease remain unknown, however, intratympanic aminoglycoside infiltration has proved to be a very effective treatment method for Meniere's disease. Therefore, currently, variable modalities of intratympanic aminoglycoside inflitration have been attempted in patients with Meniere's disease. We attempted to evaluate streptomycin perfusion for the control of vertigo with the preservation of hearing in patients with Meniere's disease. MATERIALS AND METHODS: Streptomycin powder was administered by filling up the round window niches in 15 patients with menere's disease from 1993 to 1996. Transmeatal approach was used for this technique and streptomycin infiltration was conducted for three consecutive days until patients developed spontaneous nystagmus or dizziness. RESULTS: 13 (83%) patients had no episodes of vertigo, and 2 patients had decreased vertigo attack. The preservation or improvement of hearing was reported in 87% of the patients. We observed that tinnitus disappeared in 33.3% of patients, and ear fullness in 40% of patient. After the operation, all of the patients reported to have no problems in daily activity. CONCLUSION: The streptomycin perfusion is a safe and simple procedure that is effective in controlling the vertigo, tinnitus and earfullness; however, futher further studies must be done on the preservation of hearing.