PhD Scientific Days 2020

Clinical Medicine I. Lectures

Intratympanic Gentamicin for Ménière’s Disease. Is there a Selective Vestibulotoxic Effect?

Előadó neve

Dr. Molnár, András

Előadó munkahelye

Semmelweis University, Department of Otolaryngology and Head and Neck Surgery

Előadó telefonszáma

+36204051860

Előadó e-mail címe

andrasm94@gmail.com

Az előadás címe

Intratympanic Gentamicin for Ménière’s Disease. Is there a Selective Vestibulotoxic Effect?

Szerző(k) neve és munkahelye

András Molnár MD1, Stefani Maihoub MD1, Anita Gáborján MD, PhD1, László Tamás, MD, PhD1, Ágnes Szirmai, MD, PhD1

1Department of Otolaryngology and Head and Neck Surgery/ Semmelweis University, Budapest

Szekció

Clinical Medicine I. Lectures

Language of the presentation

Hungarian

Section, first choice

Clinical Medicine

Section, second choice

Neurosciences

Összefoglaló szövege

Introduction: Ménière’s disease is a disorder characterized by vertigo, hearing loss, tinnitus, and vegetative symptoms. For intractable cases, intratympanic gentamicin could be used in clinical practice.
Aims: The aim of our study is to investigate the effectiveness and safety of the treatment, based on vertigo diaries and pure tone audiograms.
Method: The complete medical documentation of 105 definite patients (31 males, 74 females, mean age ± SD, 57.38 years ± 11.07) suffering from Ménière’s disease was analyzed. In the studied group, 9 patients were treated with intratympanic gentamicin. The application of gentamicin was carried out under a microscope, through the anteroinferior part of the tympanic membrane, using local anesthetization. 8 mg gentamicin sulphate was used, on alternate days, 2 to 4 times until acute unilateral vestibular hypofunction with typical clinical signs appeared. Long-term follow-up of the patients was carried out, using vertigo diaries, medical letters, anamnestic data, and pure tone audiograms. Audiometric results and vertigo complaints before and after treatment were contrasted using IBM SPSS V24 software, based on Mann-Whitney U test, logistic regression and survivorship curves.
Results: Based on our analysis, vertigo attacks appeared significantly less often after gentamicin treatment [p< 0.001; Odds ratio: 0.003 (95% CI: 0.001-0.012)], which confirms the efficacy of the therapy. Pure tone stages before and after the application of gentamicin were contrasted using the Mann-Whitney U test. When comparing the audiometric results of long-term follow-ups by using the logistic regression, a statistically significant difference was observed between the treated and not treated groups [p=0.001; Odds ratio: 0.141 (95% CI 0.064 – 0.313)], and based on the survivorship curve hearing impairment was more common in the not treated group, which also supports our results. Based on the non-parametric test, there was no significant difference (p= 0.84) between the pure-tone stages of the control group and of those treated with gentamicin, nor was when the lower (p= 0.49) and higher (p= 0.1) frequencies were contrasted.
Conclusion: Our results indicate that intratympanic gentamicin is effective in controlling vertigo attacks, and there is no higher risk for hearing loss than in case of spontaneous progression of the disorder.

Additional Information

Supervisor: Ágnes Szirmai
email address: agnes.szirmai@med.semmelweis-univ.hu

Bemutatás módja

Szóbeli

Kind

Szabad

Status

elfogadva

Accepted presentation method

szóbeli

Előadás fájl jóváhagyás

nem rendelkezett róla

Előadó

4091

Start

10:50

End

11:05

Authors (legacy)

András Molnár MD1, Stefani Maihoub MD1, Anita Gáborján MD, PhD1, László Tamás, MD, PhD1, Ágnes Szirmai, MD, PhD1

1Department of Otolaryngology and Head and Neck Surgery/ Semmelweis University, Budapest