Intratympanic gentamicin treatment after endolymphatic sac surgery

Gouveris, Haralampos; Lange, G.; Mann, Wolf J.

doi:10.1080/00016480510043909

Cited by 8 publications

(4 citation statements)

References 14 publications

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“…One of the major advantages of ELSS is that it does not interfere with further future treatments. In a recent paper, intratympanic gentamicin achieved complete resolution of vertigo in five patients who had undergone ELSS 16 . Although the vertigo control with vestibular neurectomy and gentamicin treatment is higher, there may be considerable imbalance after these procedures 17,18 .…”

Section: Discussionmentioning

confidence: 99%

“…In a recent paper, intratympanic gentamicin achieved complete resolution of vertigo in five patients who had undergone ELSS. 16 Although the vertigo control with vestibular neurectomy and gentamicin treatment is higher, there may be considerable imbalance after these procedures. 17,18 A significant concern with ablative procedures that result in total unilateral vestibular deafferentation is the possibility of development of Ménière's disease in the contralateral ear in the future, resulting in a vestibularly crippled patient.…”

Section: Discussionmentioning

confidence: 99%

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Caloric Function After Endolymphatic Sac Surgery

et al. 2008

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Objective: To evaluate the effect of endolymphatic sac surgery on vestibular functions using caloric testing on electronystagmography (ENG). Study Design: Retrospective chart review. Methods: The medical records of 21 adult patients with unilateral Ménière's disease who underwent endolymphatic sac surgery between 1998 and 2004 were reviewed. With use of ENG, the absolute value of the caloric response of the operated ear (i.e., the cool + warm irrigation response) and the degree of reduced vestibular response (RVR) rates as indicators of caloric functions were compared before and after surgery. Average follow‐up was 17 (6–52) months. Results: The mean change in RVR after surgery was found to be 2.9%. In total, there were six (28.5%) patients who had an RVR increase more than 10%. Of those, there were three (14.2%) patients who demonstrated an RVR increase more than 20%. Only one (4.8%) patient had an RVR increase more than 30%. Total loss of vestibular function was not observed in any of the patients. There were three (14.2%) patients who exhibited a decrease of more than 10% in their RVR. In two (9%) patients, the contralateral ear was shown to have less vestibular function than the operated side on ENG postoperatively (in one case, the absolute caloric nystagmus response remained the same in the operated ear, and in the other case, the response increased on the surgical side). When we evaluated the absolute caloric responses of the operated ear only, we found no statistical difference between the pre‐ and postoperative values (P = .219). Early results of vertigo control and hearing outcomes were comparable with those in the literature. Conclusion: Endolymphatic sac surgery does not appear to be a vestibular destructive procedure, and it is a therapeutic alternative for patients with Ménière's disease who have failed medical treatment. This is important given the possibility of bilateral disease in some patients.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Caloric Function After Endolymphatic Sac Surgery

et al. 2008

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“…However, the local application of drugs into the middle ear (via the tympanic membrane or drug delivery system) [79] is an extension of the therapeutic applications and can be easily combined with surgery, e.g., in bilateral Meniere’s disease [80], [81], [82]. …”

Section: Recent Trends In the Therapy Of Vestibular Disordersmentioning

confidence: 99%

Perspectives in vestibular diagnostics and therapy

Ernst

2011

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 10:Doc05; ISSN 1865-1011

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“…Intratympanic gentamicin injections (1) or revision surgery (2) have been used for the treatment of patients with Ménière’s disease who have relapsed following endolymphatic sac surgery (EDS) or intratympanic gentamicin injection. Ménière’s disease is a condition with vertigo, tinnitus (ringing or buzzing noises in the ears) and progressive deafness.…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of relapsed Ménière’s disease using selective serotonin reuptake inhibitors: A report of three cases

Goto

Tsutsumi

Ogawa

2013

Experimental and Therapeutic Medicine

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Patients with Ménière’s disease who have relapsed following endolymphatic sac surgery (EDS) or intratympanic gentamicin injection are occasionally treated with intratympanic gentamicin injections or revision surgery. However, there is a potential link between Ménière’s disease and anxiety or depression. The use of serotonin selective reuptake inhibitors (SSRIs) is likely be beneficial in the treatment of patients with Ménière’s disease. The aim of this report is to describe the benefits of SSRIs in patients with relapsed Meniere’s disease. Over the course of two years, three patients were treated for symptoms associated with Ménière’s disease with an SSRI (sertraline), with the complete resolution, or significant improvement, of symptoms. In these cases, the SSRI may have treated the associated morbidity and not Ménière’s disease itself. Ménière’s disease that appears to be resistant to typical otological treatment may not be just Ménière’s disease. Ménière’s disease may co-exist with three other conditions that are able to cause vestibular symptoms and respond to SSRIs: migraine-associated vertigo (MAV), panic disorders and chronic subjective dizziness (CSD).

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Intratympanic gentamicin treatment after endolymphatic sac surgery

Abstract: Complete vertigo control (class A; AAO-HNS) and hearing preservation at 0.5, 1, 2 and 3 kHz were achieved.

Cited by 8 publications

References 14 publications

Caloric Function After Endolymphatic Sac Surgery

Caloric Function After Endolymphatic Sac Surgery

Perspectives in vestibular diagnostics and therapy

Successful treatment of relapsed Ménière’s disease using selective serotonin reuptake inhibitors: A report of three cases

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