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Efficacy of intratympanic gentamicin and dexamethasone in the treatment of intractable Meniere's disease

WANG Qinglin;GUO Xiangdong;MEI Xiangsheng;LI Ying;YAO Weijie;YANG Xiaogang;Department of Nursing,Henan Medical College;Department of Otolaryngology,the First Affiliated Hospital of Henan University of TCM;  
Objective:To investigate the efficacy and safety of low-dose intratympanic gentamicin(ITG)compared with intratympanic dexamethasone(ITD)in patients with intractable Meniere's disease(MD).Method:Seventy patients affected by definite unilateral MD were enrolled.1ml of gentamicin sulfate(40g/L)was buffered with0.5ml of sodium bicarbonate to obtain a 6.4-pH solution with 26.7g/L concentration.Thirty-five patients were treated with the buffered gentamicin solution on every week for 2times.Thirty-five patients were treated with ITD(5mg)in the first two days,and then every week for 4weeks.At 2-year follow-up,mean outcome measurements consisted of control of vertigo attacks,pure tone average(PTA),dizziness handicap inventory and tinnitus handicap inventory.Result:Among 34 cases with complete follow-up data in the ITG group,complete control of vertigo(class A)was achieved in 27 patients and substantial control of vertigo(class B)in 5patients.Among 32 cases with complete follow-up data in the ITD group,class A and B were achieved in 13 and 6patients respectively(χ~2=11.330,P0.05).There were no statistically significant variations between the two groups in PTA and THI(t=1.737 and t=-0.197,P0.05).Conclusion:Low-dose ITG achieves better outcome than ITD in the control of vertigo attacks in patients suffering from unilateral intractable MD,with a very low incidence of hearing deterioration.
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