Distortion Product Otoacoustic Emissions after Intratympanic Gentamicin Therapy for Unilateral Ménière’s Disease

Vol. 10, No. 2, 2005

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Original Paper

Distortion Product Otoacoustic Emissions after Intratympanic Gentamicin Therapy for Unilateral Ménière's Disease
Nicolas Perez^a, M Boleas^a, Eduardo Martin^b

^aDepartment of Otorhinolaryngology, University Hospital and Medical School, University of Navarra, Pamplona, and
^bDepartment of Otorhinolaryngology, Hospital Casa de Salud, Valencia, Spain

Address of Corresponding Author

Audiol Neurotol 2005;10:69-78 (DOI: 10.1159/000083362)

Key Words

Gentamicin
Ménière's disease
Vertigo
Hearing loss
Deafness
Ototoxicity

Abstract

The treatment of patients with Ménière's disease that do not respond to conventional therapy becomes complicated, particularly when taking into account the issue of hearing damage as well as the control of vertigo. Treatment often involves the intratympanic administration of gentamicin, for which different protocols are used. Hence, it is important that we better understand how this treatment influences hearing, beyond mere audiometric assessments. The aim of this prospective study was to evaluate the effect of intratympanic gentamicin treatment for Ménière's disease on cochlear function, as assessed by otoacoustic emissions. The 41 patients included in the study had been diagnosed with unilateral Ménière's disease as defined by the American Academy of Otolaryngology-Head and Neck Surgery guidelines (1995), and had been refractory to medical treatment for at least 1 year. Intratympanic injections of gentamicin at a concentration of 27 mg/ml were performed at weekly intervals until indications of vestibular hypofunction appeared in the treated ear. Before beginning the treatment and 3 months after ending it, pure tone and speech audiometry tests were performed and the results are expressed in terms of the pure tone average (0.5, 1, 2, and 3 kHz) and the speech discrimination score, respectively. At the same time, a distortion product otoacoustic emission (DPOAE) study was performed and the results are expressed in terms of its presence or absence, and as the amplitude and threshold of the emission. When analyzed 3 months after the treatment had terminated, hearing loss was seen in 13 patients (31.7%). However, no significant change in the threshold and/or amplitude of otoacoustic emissions was observed in any of the patients. Neither were changes in the audiometric stage, number of injections required or the existence of DPOAE before treatment detected. Hence, the treatment method used here for patients with intractable unilateral Ménière's disease can be considered as having a low risk on auditory function, as assessed both audiometrically and with otoacoustic emissions, and can be considered as subablative for hearing function.

Author Contacts

Dr. Nicolas Perez
Departamento de Otorrinolaringología
Clínica Universitaria de Navarra, Pio XII, 36
ES-31008 Pamplona (Spain)
Tel. +34 948 255400, Fax +34 948 296588, E-Mail nperezfer@unav.es

Article Information

Received: April 6, 2004
Accepted after revision: July 29, 2004
Published online: January 12, 2005
Number of Print Pages : 10
Number of Figures : 4, Number of Tables : 5, Number of References : 25

Medline Abstract (ID 15650298)

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