RESUMO
We conducted a retrospective study to evaluate the long-term effectiveness of gentamicin applied directly to the round window membrane via the Silverstein MicroWick system in patients with definite or probable Ménière's disease. The study population was made up of 69 patients who had received 3 drops of gentamicin 10 mg/ml three times daily; the duration of treatment was guided by objective data obtained from weekly electronystagmography and audiometry. Relief of vertigo was assessed by chart review and telephone interviews. After a minimum follow-up of 24 months, we found that vertiginous symptoms remained controlled in 53 patients (76.8%) after one or more courses of drug therapy. A single course of treatmentwas successful in 41 patients (59.4%). We conclude that long-term control of vertigo can be achieved inpatients with Ménère's disease by direct application of gentamicin to the round window membrane via the Silverstein MicroWick. This minimally invasive self-treatment technique was well tolerated and free of long-term complications.
Assuntos
Antibacterianos/administração & dosagem , Sistemas de Liberação de Medicamentos , Gentamicinas/administração & dosagem , Doença de Meniere/tratamento farmacológico , Resultado do Tratamento , Vertigem/tratamento farmacológico , Administração Tópica , Adulto , Idoso , Idoso de 80 Anos ou mais , Antibacterianos/uso terapêutico , Feminino , Gentamicinas/uso terapêutico , Humanos , Masculino , Doença de Meniere/complicações , Pessoa de Meia-Idade , Estudos Retrospectivos , Fatores de Tempo , Membrana Timpânica/efeitos dos fármacos , Vertigem/etiologiaRESUMO
We conducted a study of 91 patients with severe-to-profound asymmetric hearing loss to assess their satisfaction with digital contralateral routing of signal (CROS) or bilateral contralateral routing of signal (BiCROS) hearing aids, Satisfaction was evaluated on the basis of the number of patients who elected to purchase their hearing aid following a free 30-day trial and on the results of a subsequent 8-question survey. We found that overall patient satisfaction was generally high. At the end of the 30-day trial, 66 of the 91 patients (72.5%) elected to keep their CROS or BiCROS device, a percentage that is far greater than the acceptance rates of 10 to 20% that had been previously reported with older models of the CROS and BiCROS devices. According to the survey responses, those who kept their devices gave them an overall rating of 3.4 on a scale of 1 (very dissatisfied) to 5 (very satisfied); those who returned their devices gave them an overall rating of 1.9.
