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Transtympanic gentamicin treatment using Silverstein MicroWick in Ménière's disease patients: long term outcome

R Suryanarayanan^a1 c1, V R Srinivasan^a1 and G O'Sullivan^a1

^a1 Department of Otolaryngology, Arrowe Park Hospital, Wirral, Merseyside, UK

Abstract

Objective: To assess the long term outcome of gentamicin inner-ear perfusion using the Silverstein MicroWick™ in the treatment of Ménière's disease.

Study design: Retrospective questionnaire survey of patients and review of medical records.

Setting: A district general hospital.

Participants: All 15 patients who completed a minimum follow up of at least 24 months were included.

Main outcome measures: Subjective symptoms, change in hearing thresholds and Glasgow benefit inventory scores.

Results: Based on the American Association of Otolaryngology-Head and Neck Surgery (1995) guidelines for reporting, 80 per cent of respondents obtained class A vertigo control and 20 per cent obtained class B control. Respondents' functional level improved from pre-operative levels of between three and six to post-operative levels of between one and three. Three respondents had pre-operative ‘dead ears’ and one developed the condition post-operatively. Hearing deteriorated further in three respondents, improved in two and remained unchanged in the rest. Respondents with class A control demonstrated improved quality of life, with a mean Glasgow benefit inventory total score of +34.

Conclusion: Transtympanic gentamicin therapy via the Silverstein MicroWick results in good vertigo control. Patients should however be made fully aware of the risk of hearing deterioration.

(Accepted April 01 2008)

(Online publication June 04 2008)

Key words

• Vertigo;
• Meniere's Disease;
• Gentamicin;
• Middle Ear

Correspondence:

^c1 Address for correspondence: Mr R Suryanarayanan, ENT Department, Arrowe Park Hospital, Arrowe Park Road, Upton, Wirral, CH49 5PE. E-mail: drsury@gmail.com

Footnotes

Presented at the otology section of the Royal Society of Medicine, 2 March 2007, London, UK.

Mr R Suryanarayanan takes responsibility for the integrity of the content of the paper.

Competing interests: None declared