Document Detail


Vestibular nerve section versus intratympanic gentamicin for Meniere's disease.
MedLine Citation:
PMID:  14755193     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES/HYPOTHESIS:Vestibular nerve section and transtympanic gentamicin administration are procedures with proven efficacy in the treatment of vertigo associated with Meniere's disease refractory to medical management. Hearing loss is a known complication of each of these procedures; however, there has not been a report of hearing results of both treatments from a single institution. STUDY DESIGN: Retrospective review. METHODS: Review was made of 25 patients undergoing gentamicin injection and 39 patients undergoing vestibular nerve section for Meniere's disease. Rate of vertigo control and pretreatment and post-treatment pure-tone average values and speech discrimination scores were reported. RESULTS: The mean preoperative pure-tone average for patients having vestibular nerve section was 47.2 dB, with a speech discrimination score of 75.4%. In these patients, the postoperative pure-tone average was 49.1 dB and the speech discrimination score was 75%. Patients undergoing gentamicin injection had a mean pretreatment pure-tone average of 55.9 dB and a speech discrimination score of 62%. The post-treatment pure-tone average and speech discrimination score for the gentamicin group were 68.8 dB and 49.3%, respectively. Five of 25 patients (20%) in the gentamicin treatment group and 1 of 39 (3%) in the vestibular nerve section treatment group had an increase in bone-conduction threshold greater than 30 dB. The amount of postprocedure hearing loss was significantly greater in the gentamicin treatment group (P =.006). Control of vertigo was good to excellent in 95% of the patients treated with vestibular nerve section and in 80% of the patients treated with gentamicin. CONCLUSION: Although vestibular nerve section and transtympanic gentamicin are both acceptable treatment options for vertigo associated with Meniere's disease, gentamicin causes a higher level of hearing loss related to treatment and vestibular nerve section has higher vertigo control rates.
Authors:
Todd A Hillman; Douglas A Chen; Moises A Arriaga
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The Laryngoscope     Volume:  114     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  2004 Feb 
Date Detail:
Created Date:  2004-02-02     Completed Date:  2004-03-09     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  216-22     Citation Subset:  IM    
Affiliation:
Pittsburgh Ear Associates, 429 East North Avenue, Suite 422, Pittsburgh, PA, USA.
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MeSH Terms
Descriptor/Qualifier:
Anti-Bacterial Agents / administration & dosage*
Audiometry, Pure-Tone
Gentamicins / administration & dosage*
Humans
Injections
Meniere Disease / drug therapy,  surgery,  therapy*
Postoperative Period
Questionnaires
Speech Perception
Treatment Outcome
Tympanic Membrane
Vertigo / therapy
Vestibular Nerve / surgery*
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 0/Gentamicins

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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