Kasemsuwan Lalida, Jariengprasert Chanchai, Chaturapatranont Supreeya
Department of Otolaryngology, Ramathibodi Hospital, Bangkok, Thailand.
J Med Assoc Thai. 2006 Jul;89(7):979-85.
To evaluate the effectiveness of transtympanic gentamicin treatment in Meniere's disease.
The present study is a prospective study of 8 patients in Ramathibodi Hospital who had transtympanic gentamicin treatment of Meniere's disease by fixed dose regimen of 12 injections during a period of 4 days. The committee on hearing and equilibrium guidelines for reporting treatment results in Meniere's disease of the American Academy of Otolaryngology and Head & Neck Surgery (1995) were used. Paired t-test or Wilcoxon Signed Ranks Test was used for statistical comparisons.
Among 8 patients, there were 2 males and 6 females. All patients (100%) had either complete (37.5%) or substantial (62.5%) control of vertigo. Disability was also improved in all of the subjects (100%). Tinnitus was improved in 62.5%. Their tinnitus score and functional level scale were much improved with statistical significance (p = 0.001, p < 0.005, respectively). Hearing was unchanged in 87.5% and slightly worse in 12.5%. This was not significant.
Transtympanic gentamicin treatment was found to be an effective treatment option for patients with disabling or intractable Meniere's disease, with a low incidence of hearing loss. The use of this method appears to be practical and may replace the vestibular surgery.
评估鼓室内注射庆大霉素治疗梅尼埃病的有效性。
本研究是一项前瞻性研究，对拉玛蒂博迪医院的8例梅尼埃病患者采用固定剂量方案，在4天内进行12次鼓室内注射庆大霉素治疗。采用美国耳鼻咽喉头颈外科学会（1995年）制定的关于梅尼埃病治疗结果报告的听力与平衡委员会指南。采用配对t检验或威尔科克森符号秩检验进行统计学比较。
8例患者中，男性2例，女性6例。所有患者（100%）的眩晕均得到完全（37.5%）或显著（62.5%）控制。所有受试者（100%）的失能状况也得到改善。耳鸣改善率为62.5%。他们的耳鸣评分和功能水平量表有显著改善（分别为p = 0.001，p < 0.005）。87.5%的患者听力无变化，12.5%的患者听力稍有下降。这无统计学意义。
鼓室内注射庆大霉素治疗对致残性或难治性梅尼埃病患者是一种有效的治疗选择，听力损失发生率低。该方法的应用似乎切实可行，可能会取代前庭手术。
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