Intratympanic Treatment in Menière's Disease, Efficacy of Aminoglycosides Versus Corticosteroids in Comparison Studies

Abstract

Objective: To compare the functional outcomes and complications of intratympanic gentamicin (ITG) versus intratympanic corticosteroids (ITC) in Menière's disease. Data Sources: An electronic search was conducted in the Cochrane Library, PubMed, and Embase databases on February 3, 2019. Articles written in English, Dutch, German, French, or Turkish language were included. Study Selection: Study inclusion criteria were: 1) patients diagnosed with definite Menière's disease according to the criteria of the American Academy of Otolaryngology-Head and Neck Surgery, 2) treated with ITG or ITC in a comparison study, and 3) reported subjective and objective outcomes concerning Menière's disease. Data Extraction: The quality of eligible studies was assessed according to an adjusted version of the Cochrane Risk of Bias tool. The extracted data were study characteristics (study design, publication year, and number of relevant patients), patient's characteristics (sex and age), disease characteristics (uni or bilateral and duration of Menière's disease), treatment protocol, and different therapeutic outcomes (vertigo, tinnitus, aural fullness, and hearing loss). Data Synthesis: A total of eight articles were included for data extraction and analysis. For subjective outcomes, ITG was slightly favored compared to intratympanic corticosteroids. This was significant only in three studies (p < 0.05). For objective outcomes and complications, no significant differences were seen. Conclusions: The result of this systematic review shows some benefit of ITG over ITC for subjective outcomes and no difference regarding objective outcomes or complication rate. However, this superiority of ITG is rather weak. Both interventions can be effectively and safely used in controlling Menière's disease in acute situations.

Influence of data mining technology in information analysis of human resource management on macroscopic economic management

“…Classification can describe and predict the rules, in which decision trees are one of the principal methods. Cluster analysis is based on similarity, summarizing relevant data into different categories before analyzing them [ 15 , 16 ]. Because of the various types of data involved in HRM, decision tree algorithms’ application and effectiveness are discussed herein.…”

Current Insights into Treating Vertigo in Older Adults

“…Obviously, young patients are the best candidates for an easier achievement of vestibular compensation. The great advantage of labyrinthine ablation with gentamicin is based on the minimally invasive nature of the procedure and on the demonstration that it is not necessary to achieve total destruction of the neurosensory structures of the vestibule to achieve the desired therapeutic effect [91].…”

Intratympanic gentamicin injection in Ménière’s disease: our experience and outcomes

“…Nowadays there is an international consensus on diagnosis of MD while there is still no general consensus on the most appropriate treatment to be adopted 1,4 .Although treatment of medical refractory unilateral MD with IT aminoglycoside injections has nowadays a standard therapy, there is still no consensus on the doses and timing of administration 4,5 . The IT aminoglycoside injections was first introduced by Schuknecht using streptomycin and then by Lange using gentamicin.…”

“…MD exhibits a relapsing-remitting pattern, with episodic attacks terminated by periods of restitution to normal auditory and vestibular function. Additionally, auditory and vestibular function decline over time.Although the pathophysiologic mechanism of MD is well accepted, the underlying causes remains uncertain 1 . MD treatment is still objective of controversies in literature and it must be first based on a trustable diagnosis, as recommended by guidelines and classification of the AAO-HSN published in 1995 2 and reviewed by the Equilibrium Committee in 2015 3 .…”

“…MD has a considerable negative effect on patient's quality of life so current therapies are directed to prevent or reduce the frequency and severity of vertigo crises 4 . Intratympanic injection of gentamicin(ITG) is considered the treatment of choice in patients with refractory disease 1,4 . However due to its possible hearing side effects there is still no general consensus on dose and timing of ITG 4 .…”