Odkvist L M
Department of Otolaryngology, Linköping University, Sweden.
Acta Otolaryngol Suppl. 1989;457:83-6.
Twenty-nine patients seriously disabled by Ménière's disease due to frequent attacks were treated with Gentamicin administered in the middle ear once daily until first sign of an inner ear disturbance, usually a spontaneous nystagmus and a sensation of unsteadiness. All patients except one were relieved from their vertiginous attacks and returned to normal activities. Tinnitus was usually diminished or absent, as was the feeling of pressure in the ear. The hearing was slightly improved in 5 patients, worse in 9 patients and two treated ears became deaf. The indication for an intratympanal treatment with Gentamicin should be a disabling form of Ménière's disease not responding to medical treatment. The risk for the cochlea increases after 6 days of treatment. The advantage versus intracranial surgery is the absence of the surgical risks for complications. The mode of action exerted by the ototoxic drug is a destruction of the vestibular sensory epithelium and the endolymph producing cells.
29例因梅尼埃病频繁发作而严重致残的患者接受了中耳每日一次庆大霉素治疗，直至出现内耳功能紊乱的首个迹象，通常是自发性眼球震颤和不稳感。除1例患者外，所有患者的眩晕发作均得到缓解并恢复正常活动。耳鸣通常减轻或消失，耳部压迫感也如此。5例患者听力稍有改善，9例患者听力变差，2只接受治疗的耳朵失聪。庆大霉素鼓室内注射治疗的适应证应为药物治疗无效的致残型梅尼埃病。治疗6天后耳蜗受损风险增加。与颅内手术相比，其优势在于不存在手术并发症风险。耳毒性药物的作用方式是破坏前庭感觉上皮和内淋巴生成细胞。
