TY - JOUR
T1 - Exploratory tympanotomy and gentamicin application in patients with intractable Meniere's Disease
AU - Koo, Ja Won
AU - Rah, Yoon Chan
PY - 2016/12/1
Y1 - 2016/12/1
N2 - Intractable disease is reported by 10%-15% of patients with vertigo, even after medical treatment and an intratympanic injection of gentamicin. In these cases, the therapeutic options are definitive ablative procedures, such as vestibular neurectomy or labyrinthectomy. However, both procedures are inevitably accompanied by surgical morbidity. Exploratory tympanotomy with gentamicin application has been suggested as a reasonable intermediate surgical option before attempting definitive ablative procedures. This procedure can eradicate intratympanic anatomical problems that might interrupt gentamicin delivery into the inner ear and enables confirmation of the prolonged and direct contact of the drug with the oval window and the round window membrane. In our case series analysis, out of 94 patients who received intratympanic gentamicin injection, 10 patients (10.5%) could not reach class A or class B. Among them, 7 patients underwent exploratory tympanotomy and gentamicin application, and complete control of vertigo (class A) was achieved in 5 patients (71%). With the advantage of its minimal surgical burden, exploratory tympanotomy and gentamicin application may be a reasonable surgical option before considering definitive ablative procedures.
AB - Intractable disease is reported by 10%-15% of patients with vertigo, even after medical treatment and an intratympanic injection of gentamicin. In these cases, the therapeutic options are definitive ablative procedures, such as vestibular neurectomy or labyrinthectomy. However, both procedures are inevitably accompanied by surgical morbidity. Exploratory tympanotomy with gentamicin application has been suggested as a reasonable intermediate surgical option before attempting definitive ablative procedures. This procedure can eradicate intratympanic anatomical problems that might interrupt gentamicin delivery into the inner ear and enables confirmation of the prolonged and direct contact of the drug with the oval window and the round window membrane. In our case series analysis, out of 94 patients who received intratympanic gentamicin injection, 10 patients (10.5%) could not reach class A or class B. Among them, 7 patients underwent exploratory tympanotomy and gentamicin application, and complete control of vertigo (class A) was achieved in 5 patients (71%). With the advantage of its minimal surgical burden, exploratory tympanotomy and gentamicin application may be a reasonable surgical option before considering definitive ablative procedures.
KW - Gentamicin
KW - Intractable disease
KW - Meniere's Disease
KW - Surgery
UR - http://www.scopus.com/inward/record.url?scp=85006240177&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85006240177&partnerID=8YFLogxK
U2 - 10.1016/j.otot.2016.10.006
DO - 10.1016/j.otot.2016.10.006
M3 - Article
AN - SCOPUS:85006240177
VL - 27
SP - 210
EP - 215
JO - Operative Techniques in Otolaryngology - Head and Neck Surgery
JF - Operative Techniques in Otolaryngology - Head and Neck Surgery
SN - 1043-1810
IS - 4
ER -