Efficacy of Increased Gentamicin Concentration for Intratympanic Injection Therapy in Ménière's Disease

Abou-Halawa, Ashraf Saad; Poe, Dennis S.

doi:10.1097/00129492-200207000-00018

Cited by 23 publications

(28 citation statements)

References 17 publications

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“…Although Abou-Halawa and Poe [7] have shown that 40 mg/ml is as effective as lower doses and requires fewer applications, we have chosen 30 mg/ml to remain on the safe side concerning possible cochlear damage and because application of gentamicin through a ventilation tube is not uncomfortable at all. In the gentamicin group both the scores for vertigo and aural fullness after 1 year were lower than at the start of the trial (Figures 3 and 4).…”

Section: Discussionmentioning

confidence: 99%

Intratympanic gentamicin therapy for control of vertigo in unilateral Menière's disease: a prospective, double-blind, randomized, placebo-controlled trial

Postema¹,

Kingma²,

Wit³

et al. 2008

Acta Oto-Laryngologica

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Section: Discussionmentioning

confidence: 99%

Intratympanic gentamicin therapy for control of vertigo in unilateral Menière's disease: a prospective, double-blind, randomized, placebo-controlled trial

Postema¹,

Kingma²,

Wit³

et al. 2008

Acta Oto-Laryngologica

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“…A pair of high frequency transducers were coupled with the IHS system to generate specific acoustic stimuli that were presented at a rate of 37.1 per second. ABR thresholds were measured in response to toneburst stimuli with 1 ms rise/fall and 0 ms plateaus, gated by a Blackman envelope, and centered at frequencies of 4,8,12,16, and 32 kHz. Evoked potentials were band-pass-filtered between 30 and 3000 Hz.…”

Section: Auditory Assessmentmentioning

confidence: 99%

“…Although gentamicin is mainly toxic to the vestibule, ototoxicity is an important concern and can be encountered in up to 34% of the treated patients depending on the dose regimen and number of injections [1] . Different ITG application protocols have been described recently in order to achieve complete or substantial vertigo control with minimal risk of ototoxicity [2][3][4][5][6] . Despite these efforts, ITG is not an ideal treatment option for patients with serviceable hearing and/or bilateral MD.…”

Section: Introductionmentioning

confidence: 99%

Cochlear and Vestibular Effects of Combined Intratympanic Gentamicin and Dexamethasone

Günerı

Olgun²,

Aslıer³

et al. 2017

Int Adv Otol

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OBJECTIVE:The aim of this study is to evaluate the effects of an intratympanic gentamicin-dexamethasone combination on the inner ear. MATERIALS and METHODS:Twenty-six Wistar albino rats were divided into four groups: Group I (Control), group II (Intratympanic dexamethasone; ITD), group III (Intratympanic gentamicin; ITG), and group IV (Intratympanic gentamicin and dexamethasone; ITGD). On the first day after basal auditory brainstem response (ABR) measurements, the ITG group received 0.03 mL of intratympanic gentamicin (26.7 mg/mL). Intratympanic injection of 0.06 mL of a solution containing 13.35 mg/mL gentamicin and 2 mg/mL dexamethasone was performed in the ITGD group. 0.03 mL of physiological intratympanic serum and dexamethasone (4 mg/mL) was applied in control and ITD groups, respectively. On the 7 th day, ABR measurements were repeated and vestibular functions were evaluated. On the 21 th day, ABR and vestibular tests were repeated, and the animals were sacrificed for histopathological investigation. RESULTS:The ITG group's hearing thresholds deteriorated in all frequencies. The ITGD group's hearing thresholds were significantly better than the ITG group, except at 8 kHz on the 7 th day and in all frequencies at the 21 th day measurements. The vestibular function scores of the ITG and ITGD groups were higher than the controls. Apoptotic changes were seen in cochlea, spiral ganglion, and vestibule of the ITG group. Cochlear and vestibular structures were well preserved in the ITGD group, similar to the controls. CONCLUSION:The ITGD combination led to a significant hearing preservation. Although in subjective vestibular tests, it seemed that vestibulotoxicity was present in both ITG and ITGD groups the histopathological investigations revealed no signs of vestibulotoxicity in the ITGD group in contrast to the ITG group. Further studies using a combination of different concentrations of gentamicin and dexamethasone are needed.

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“…The dosages and timing of therapy as well as endpoints selected to curtail therapy differ greatly among published reports (Youssef and Poe 1998, Minor 1999, Harner et al 2001, Abou-Halawa and Poe 2002, Chia et al 2004). In one series by Minor, 34 patients were evaluated in a protocol designed to determine clinical endpoints for cessation of intratympanic gentamicin therapy (Minor 1999).…”

Section: Medications Applied To the Middle Ear For Inner Ear Absorptionmentioning

confidence: 99%

Drug Delivery for Treatment of Inner Ear Disease: Current State of Knowledge

McCall

Swan²,

Borenstein³

et al. 2010

Ear &Amp; Hearing

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Delivery of medications to the inner ear has been an area of considerable growth in both the research and clinical realms over the past several decades. Systemic delivery of medication destined for treatment of the inner ear is the foundation upon which newer delivery techniques have been developed. Due to systemic side effects, investigators and clinicians have begun developing and utilizing techniques to deliver therapeutic agents locally. Alongside the now commonplace use of intratympanic gentamicin for Meniere's disease and the emerging use of intratympanic steroids for sudden sensorineural hearing loss, novel technologies, such as hydrogels and nanoparticles, are being explored. At the horizon of inner ear drug delivery techniques, intracochlear devices that leverage recent advances in microsystems technology are being developed to apply medications directly into the inner ear. Potential uses for such devices include neurotrophic factor and steroid delivery with cochlear implantation, RNA interference technologies, and stem cell therapy. The historical, current, and future delivery techniques and uses of drug delivery for treatment of inner ear disease serve as the basis for this review.

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Efficacy of Increased Gentamicin Concentration for Intratympanic Injection Therapy in Ménière's Disease

Cited by 23 publications

References 17 publications

Intratympanic gentamicin therapy for control of vertigo in unilateral Menière's disease: a prospective, double-blind, randomized, placebo-controlled trial

Intratympanic gentamicin therapy for control of vertigo in unilateral Menière's disease: a prospective, double-blind, randomized, placebo-controlled trial

Cochlear and Vestibular Effects of Combined Intratympanic Gentamicin and Dexamethasone

Drug Delivery for Treatment of Inner Ear Disease: Current State of Knowledge

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