Kyrodimos E, Aidonis I, Sismanis A
Department of Otolaryngology-Head and Neck Surgery, Virginia Commonwealth University Medical Center, Richmond, Virginia 23298, USA.
J Laryngol Otol. 2009 Apr;123(4):379-82. doi: 10.1017/S0022215108003150. Epub 2008 Oct 28.
To evaluate hearing results following intratympanic gentamicin perfusion in patients with Ménière's disease.
Middle-ear perfusion of 0.4 ml of gentamicin 40 mg/ml solution was performed in Ménière's disease patients who had previously failed to respond to other medical treatment.
Between May 1999 and November 2005, 22 patients (mean age 58.5 years) underwent intratympanic gentamicin perfusion. Mean follow up was 30 months. At the first post-perfusion visit (four to six weeks following perfusion), three of the 22 patients (13.63 per cent) had a pure tone average improvement of at least 10 dB, 15 (68.18 per cent) showed no change and four (18.18 per cent) demonstrated a decrease in hearing of more than 10 dB. Regarding speech discrimination scores, one patient (4.54 per cent) exhibited an improvement of at least 15 per cent, 15 (68.18 per cent) showed no change and six (27.27 per cent) showed a decrease of at least 15 per cent. After long-term follow up (12-40 months following perfusion), 10 patients (45.45 per cent) showed stable hearing, and 12 (54.54 per cent) exhibited a pure tone average decrease of more than 10 dB. Six patients (27.27 per cent) showed a speech discrimination score decrease of at least 15 per cent, while 16 (72.72 per cent) had no change. Complete cessation of vertigo was reported by 20 of the 22 patients (90.9 per cent), while two (9.09 per cent) reported episodic vertigo spells.
Intratympanic gentamicin perfusion provides effective control of vertigo in patients with Ménière's disease. However, significant hearing loss may occur immediately after perfusion; therefore, this treatment should be considered only for patients whose hearing has already been affected by the disease.
评估梅尼埃病患者鼓室内灌注庆大霉素后的听力结果。
对先前其他药物治疗无效的梅尼埃病患者进行中耳灌注0.4毫升40毫克/毫升的庆大霉素溶液。
1999年5月至2005年11月期间，22例患者（平均年龄58.5岁）接受了鼓室内庆大霉素灌注。平均随访30个月。在灌注后的首次随访（灌注后四至六周）时，22例患者中有3例（13.63%）纯音平均提高至少10分贝，15例（68.18%）无变化，4例（18.18%）听力下降超过10分贝。关于言语辨别得分，1例患者（4.54%）提高至少15%，15例（68.18%）无变化，6例（27.27%）下降至少15%。长期随访（灌注后12 - 40个月）后，10例患者（45.45%）听力稳定，12例（54.54%）纯音平均下降超过10分贝。6例患者（27.27%）言语辨别得分下降至少15%，16例（72.72%）无变化。22例患者中有20例（90.9%）报告眩晕完全停止，2例（9.09%）报告有发作性眩晕发作。
鼓室内庆大霉素灌注可有效控制梅尼埃病患者的眩晕。然而，灌注后可能立即出现明显听力损失；因此，仅应考虑对听力已受该病影响的患者采用这种治疗方法。
