Parnes L S, Riddell D
Department of Otolaryngology, University of Western Ontario, London, Canada.
Laryngoscope. 1993 Jul;103(7):745-9. doi: 10.1288/00005537-199307000-00007.
Intratympanic aminoglycosides were first used to treat unilateral intractable Meniere's disease over 30 years ago. Gentamicin, the current drug of choice, provides excellent vertigo control with a low incidence of hearing loss. Its salutory effect results from direct damage to both the sensory neuroepithelium and the dark cells of the labyrinth. This latter effect may reverse the degree of endolymphatic hydrops. Twelve patients with unilateral Meniere's disease were treated and prospectively studied. Although further follow-up is necessary, 10 patients have complete vertigo control, while 2 remain significantly improved. Three patients developed a spontaneous "irritative" nystagmus during the early post-treatment period. This new unique finding may represent a recovery phenomenon resulting from a temporary reversible ototoxic effect in the treatment ear. Despite our patients having a somewhat higher incidence of hearing loss compared to the reported rate, the results of this treatment are encouraging.
鼓室内注射氨基糖苷类药物早在30多年前就首次用于治疗单侧难治性梅尼埃病。目前的首选药物庆大霉素能有效控制眩晕，听力损失发生率低。其有益效果源于对感觉神经上皮和迷路暗细胞的直接损伤。后一种作用可能会逆转内淋巴积水的程度。对12例单侧梅尼埃病患者进行了治疗并进行前瞻性研究。尽管有必要进一步随访，但10例患者的眩晕得到了完全控制，2例仍有明显改善。3例患者在治疗后的早期出现了自发性“刺激性”眼球震颤。这一独特的新发现可能代表了治疗耳中暂时可逆的耳毒性作用导致的恢复现象。尽管与报道的发生率相比，我们的患者听力损失发生率略高，但这种治疗结果令人鼓舞。
