Outcomes of Intratympanic Gentamicin Injection to Treat Ménière’s Disease

@article{Huon2012OutcomesOI,
  title={Outcomes of Intratympanic Gentamicin Injection to Treat M{\'e}ni{\`e}re’s Disease},
  author={L K Huon and Te-Yung Fang and Pa-Chun Wang},
  journal={Otology \& Neurotology},
  year={2012},
  volume={33},
  pages={706–714}
}
Objective To investigate the outcomes of intratympanic (IT) gentamicin sulfate injection to treat intractable Ménière’s disease (MD) using evidence-based methods. Data Source Data were retrieved from a MEDLINE search (January 1995 through January 2011). Study Selection Selected were English-language articles presenting outcomes of IT gentamicin injection to treat MD that had a prospective study design and an evidence level of II or higher. Data Extraction The database was searched using Boolean… 
The Clinical Outcomes After Intratympanic Gentamicin Injection to Treat Menière's Disease: A Meta-analysis.
TLDR
Overall, the results seem to provide the limited evidence about efficacy and toxicity effects of ITG, however, clinical outcomes require further confirmation.
Intratympanic (IT) Therapies for Menière’s Disease: Some Consensus Among the Confusion
TLDR
IT injections of aminoglycosides and corticosteroids can improve vertigo control but hearing and vestibular loss however may result with IT aminglycosides.
Intratympanic Gentamicin for Ménière’s Disease
TLDR
LD-ITG allows obtaining good results in term of vertigo attacks associated with a limited occurrence of side effects, and ran less risk of needing repeated rounds, but retreatment was ineffective in 40% of the cases requiring surgical therapy.
Comparing Intratympanic Gentamicin with Methylprednisolone in Meniere’s Disease with Non-Serviceable Hearing
TLDR
In patients with unilateral intractable MD with non-serviceable hearing, high fixed doses of both intratympanic gentamicin and methylprednisolone are effective in alleviating disease symptoms in long term follow-up.
Vestibular results after intratympanic gentamicin therapy in disabling Menière’s disease
TLDR
It is demonstrated that a profound vestibular deafferentation confirmed with multifrequency test evaluation is needed to have a subjective improvement in the treatment of unilateral disabling Menière’s disease with intratympanic gentamicin.
Intratympanic gentamycine for Ménière’s disease: is there a selective vestibulotoxic effect?
TLDR
The results indicate that intratympanic gentamycine is effective in controlling vertigo attacks, and there is no higher risk for hearing loss than in case of spontaneous progression of the disorder.
Repeated courses of intratympanic dexamethasone injection are effective for intractable Meniere’s disease
TLDR
Intra-tympanic dexamethasone injection (ITD) could serve as a first-line intra-Tympanic (IT) treatment for Meniere’s disease (MD), regardless of hearing level, if administered on demand.
Chemical labyrinthectomy for the worse ear of adult Nigerians with bilateral Meniere’s disease: preliminary report of treatment outcomes
TLDR
The variable titration method using low-dose intratympanic gentamycin directed at worse ear of adult Nigerians with bilateral Meniere’s disease appears to be highly effective.
Comparison the Efficacy of Intratympanic Injections of Methylprednisolone and Gentamicin to Control Vertigo in Unilateral Meniere’s Disease
TLDR
Low-dose gentamicin may be a relatively safe and effective therapy in the treatment of intractable MD, providing superior vertigo control compared with intratympanic methylprednisolone.
Intratympanic gentamicin treatment ‘as needed’ for Meniere’s disease. Long-term analysis using the Kaplan–Meier method
TLDR
The Kaplan–Meier survival analysis provided an excellent method for reporting treatment success or failure in patients followed for variable length of time with this kind of protocol.
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TLDR
Intratympanic gentamicin appears effective in controlling the symptoms of Meniere's disease, regardless of the protocol used.
[Intratympanic gentamicin in Menière's disease].
TLDR
Intratympanic gentamicin injection is a simple and cost-effective means for controlling intractable vertigo of Menière's disease, but it also has some toxic effect to hearing.
Intratympanic gentamicin for Ménière's disease or syndrome.
TLDR
Based on the results of the two included studies, intratympanic gentamicin seems to be an effective treatment for vertigo complaints in Ménière's disease, but carries a risk of hearing loss.
Intratympanic Gentamicin Therapy for Ménière’s Disease: A Meta-analysis
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    Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology
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TLDR
This study compared the effectiveness of five different techniques of intratympanic gentamicin administration for Ménière’s disease using a parametric empirical Bayes analysis based on binomial generalized linear models and backward variable selection.
Hearing Loss after Intratympanic Gentamicin Therapy for Unilateral Ménière's Disease
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TLDR
Ending weekly intratympanic injections when clinical signs of vestibular deafferentation appear results in the control of vertigo in the majority of patients and the hearing changes detected during the treatment are transitory and are the only clinical sign that predicts the response to gentamicin instillation.
Long-Term Follow-Up of Transtympanic Gentamicin for Méniére's Syndrome
TLDR
It appears that a single transtympanic gentamicin injection is effective in controlling the vertigo of Méniére's syndrome, most useful for those patients who have failed medical management and are severely affected but not totally incapacitated by the disease.
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TLDR
It is demonstrated that, in patients with Ménière's disease, 0.5 ml doses of gentamicin solution, with a concentration of 20 mg/ml, injected intratympanically once a week minimize the risk of hearing loss in the treated ear, permitting complete control of vertigo in more than half of cases after 2 doses and in almost all subjects (93%) after 4 doses.
Intratympanic gentamicin for control of vertigo in Meniere's disease: vestibular signs that specify completion of therapy.
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TLDR
Ending weekly intratympanic gentamicin injections when clinical signs of unilateral vestibular hypofunction appear can control vertigo in most patients.
Intratympanic gentamicin therapy for control of vertigo in unilateral Menière's disease: a prospective, double-blind, randomized, placebo-controlled trial
Conclusions. Intratympanic application of gentamicin is a relatively safe and efficient treatment for the reduction of complaints of vertigo attacks associated with Menière's disease. The treatment
Factors Relating to the Vertigo Control and Hearing Changes Following Intratympanic Gentamicin for Intractable Ménière's Disease
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TLDR
The data indicate that the frequency of Vertigo is not a key factor in the vertigo control after GM injections, that induction of vestibular damage in the injected ear is essential for the control of vertigo and this effect is mostly pronounced in patients with milder hearing loss, and that hearing improvement is not only a consequence of good Vertigo control but also affected by the stress level before treatment.
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