Comparison the Efficacy of Intratympanic Injections of Methylprednisolone and Gentamicin to Control Vertigo in Unilateral Meniere’s Disease
Mozafar Sarafraz1, Nader Saki1, Soheila Nikakhlagh1, Leila Mashali1 And Armin Arad2*1Department of Otolaryngology, Head and neck surgery, Hearing & Speech Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran. 2Student Research Committee, Hearing & Speech Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran .
Abstract: Meniere’s disease (MD) is the most common form of endolymphatic hydrops with unknown etiology. Although various medical and surgical treatments have been introduced for this condition, there is still no definite cure for MD. The present study aims to comparatively evaluate the therapeutic effects of gentamicin perfusion and steroid therapy by methylprednisolone in controlling the vertigo among the unilateral MD patients Twenty patients with unilateral MD patients were enrolled in this study according to the guidelines of the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS). The subjects who had not previously responded to the treatment for at least 3 months were included. Ten cases received injection of gentamicin solution. The gentamicin solution was injected under a microscope using a 25 needle. Likewise, 10 patients underwent intratympanic methylprednisolone injection 3 times a week. The response rate for the treatment of vertigo was evaluated based on AAO-HNS guidelines. After the intervention, tinnitus was observed in 45.5% of the gentamicin group, while in 54.4% of the methylprednisolone receiving group 54.4% (P>0.05). Vertigo was controlled in 70% of the patients in the gentamicin group and 50% in methylprednisolone group (0.085). The reduction of PTA was significantly higher in patients received gentamicin, compared with the subjects received methylprednisolone (P=0.035). Low-dose gentamicin may be a relatively safe and effective therapy in the treatment of intractable MD, providing superior vertigo control compared with intratympanic methylprednisolone.
Keywords: Meniere’s Disease; Methylprednisolone; Gentamicin; Vertigo Back to TOC