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Changes in the Angular Vestibulo‐Ocular Reflex after a Single Dose of Intratympanic Gentamicin for Ménière's Disease
Author(s) -
CAREY J. P.,
HIRVONEN T.,
PENG G.C. Y.,
DELLA SANTINA C. C.,
CREMER P. D.,
HASLWANTER T.,
MINOR L. B.
Publication year - 2002
Publication title -
annals of the new york academy of sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.712
H-Index - 248
eISSN - 1749-6632
pISSN - 0077-8923
DOI - 10.1111/j.1749-6632.2002.tb02888.x
Subject(s) - medicine , otorhinolaryngology , ophthalmology , surgery
Ménière's disease is an inner ear disorder that causes episodic vertigo, hearing loss, tinnitus, and fullness in the ear. The clinical disorder has been associated with hy- drops, a distension of the endolymphatic fluid compartment of the inner ear. The ma- jority of patients can successfully control their attacks of vertigo with diuretics and restriction of sodium intake. However, about 30% of patients with Ménière's disease have intractable vertigo that does not respond to these measures. The intratympanic (middle ear) injection of gentamicin is now an alternative to ablative surgery for these patients. Gentamicin is an aminoglycoside antibiotic that is toxic to the hair cells of the inner ear, with somewhat greater vestibular toxicity than cochlear toxic- ity. We have treated 102 patients with unilateral Ménière's disease with intratympan- ic gentamicin. Attacks of vertigo have been completely controlled in 83%, and substantially controlled (>60% reduction in frequency) in 12%. Profound hearing loss occurred as a result of treatment in only 2%, and the overall rate at which hear- ing declined after treatment (19%) did not differ from the expected decline in hear- ing with active Ménière's disease. Recent evidence suggests that a single dose of intratympanic gentamicin can be effective in controlling vertigo in Ménière's disease.1 This study was undertaken to determine the effect of a single intratympanic injection of gentamicin on the function of the human angular vestibulo-ocular reflex (AVOR) in subjects with Ménière's disease.