High Concenration Intratympnic Gentamicin Injection Technique in Intractable Meniere's Disease

초록

Background: Intratympanic gentamicin therapy is one of the few new frontiers in treatment of Meniere's disease and may replace vestibular surgery. Many papers have reported high success rates in treating episodic vertigo of Meniere's disease, but technique, dose, duration, and treatment philosophy varied considerably. But hearing loss was typically reported in about 30% of patients. The purpose of this paper is to describe the efficacy of a low dose, high concentration, long interval technique for gentamicin therapy. Method: Four patients who were diagnosed with intractable Meniere's disease, based on the 1995 guidelines of the American Academy of Otolaryngology-Head and Neck Surgery, were selected. Each patient received a ventilation tube on the lesion side, and then gentamicin was infused as 0.3cc of an 80mg/ml solution at weekly interval for a total of 3 times by 25 guage spinal needle, The ending time is determined by a new vertigo attack or decreasing gain on SHA testing. All patients were evaluated by questionnaire and pure tone audiometer(included 8000-12000Hz). Result: In two patients, all three injections were required. For 24 months follow up period, vertigo was controlled well in all patients and hearing level was improved in two patients. Conclusion: The high concentration gentamicin injection method is a simple and effective method to treat intractable Meniere's disease.