Wu Iee Ching, Minor Lloyd B
Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
Laryngoscope. 2003 May;113(5):815-20. doi: 10.1097/00005537-200305000-00009.
To determine the long-term hearing outcome in patients with intractable vertigo caused by unilateral Ménière's disease who were treated with intratympanic injection of gentamicin.
The study was a longitudinal analysis of hearing and control of vertigo in patients with unilateral Ménière's disease who received intratympanic gentamicin.
Pure-tone thresholds and speech discrimination scores on audiometry were analyzed, along with the control of vertigo. Criteria described in 1995 by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) were used. Patients treated with intratympanic gentamicin had "definite" Ménière's disease and had intractable vertigo despite optimal medical therapy, no symptoms suggestive of Ménière's disease in the contralateral ear, and serviceable hearing in the contralateral ear. The study analyzed the outcomes of 34 patients for whom follow-up data were available for periods greater than 24 months after intratympanic gentamicin.
Complete control of vertigo (AAOHNS Class A) was obtained in 90% of the patients. Profound sensorineural hearing loss occurred as a result of gentamicin injection in 1 of the 34 patients (3%). When data from all patients were grouped together, hearing was improved in 5 (15%), unchanged in 23 (68%), and worse in 6 (17%) patients. This distribution of hearing outcome is similar to that in patients whose symptoms of Ménière's disease were managed with medical measures. Recurrent vertigo developed in 10 patients (29%) at an interval of 4 to 15 months after initially complete control. Treatment with additional intratympanic injection(s) of gentamicin did not result in a change in hearing.
The risk of hearing loss in patients treated with infrequent intratympanic injection(s) of gentamicin is low.
确定接受庆大霉素鼓室内注射治疗的单侧梅尼埃病所致顽固性眩晕患者的长期听力结果。
该研究是对接受鼓室内庆大霉素治疗的单侧梅尼埃病患者的听力和眩晕控制情况进行的纵向分析。
分析纯音听阈和听力计上的言语辨别得分以及眩晕控制情况。采用美国耳鼻咽喉头颈外科学会（AAO-HNS）1995年描述的标准。接受鼓室内庆大霉素治疗的患者患有“明确的”梅尼埃病，尽管接受了最佳药物治疗仍有顽固性眩晕，对侧耳无梅尼埃病症状提示，且对侧耳听力尚可。该研究分析了34例患者的结果，这些患者在鼓室内注射庆大霉素后有超过24个月的随访数据。
90%的患者眩晕得到完全控制（AAOHNS A级）。34例患者中有1例（3%）因庆大霉素注射出现重度感音神经性听力损失。当将所有患者的数据汇总在一起时，5例（15%）患者听力改善，23例（68%）患者听力无变化，6例（17%）患者听力变差。这种听力结果的分布与采用药物措施治疗梅尼埃病症状的患者相似。10例患者（29%）在最初完全控制后4至15个月出现复发性眩晕。额外进行鼓室内庆大霉素注射治疗并未导致听力改变。
不频繁进行鼓室内注射庆大霉素治疗的患者发生听力损失的风险较低。
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