Use of gentamicin and dexamethasone protects hearing and vertigo control in Meniere's disease

Meniere's disease is a condition of the inner ear that leads to hearing loss and dizzy spells (vertigo). The disorder is more frequent in young and middle-aged adults. In most people, Meniere's disease affects only one ear.

Chemical labyrinthectomy using gentamicin is a popular treatment of intractable vertigo attacks in Meniere's disease. However, hearing loss risk remains a major concerning factor for clinicians. Considering this, Sung Huhn Kim and colleagues examined the effect of simultaneous application of gentamicin and dexamethasone on vertigo control and hearing preservation in patients having intractable unilateral Meniere's disease.

For this purpose, the researchers conducted a single-institutional, prospective, single-blinded, randomized clinical trial from 2016-2020. Direct application of gentamicin-soaked Gelfoam was made to the oval window after middle ear exploration. On the round window, dexamethasone-soaked Gelfoam was applied in the gentamicin with the dexamethasone group (GD group, n = 18). Saline-soaked Gelfoam was used in the gentamicin with a sham reagent group (GO group, n = 19). The hearing change was investigated eight weeks after the procedure, and vertigo control 2–12 months after the process.

Key findings include:

• The high-frequency hearing threshold was significantly increased in the GO group (p = 0.005 and 0.012 for 4 and 8 kHz, respectively) but not in the GD group.
• The short-term (2–6 months) vertigo control was more successful in the GD group (57.89% vs. 94.44%), but the long-term management (6–12 months) was insignificant.

"The combined application of dexamethasone and gentamicin in chemical labyrinthectomy is an effective method for protecting high-frequency hearing and vertigo control," the researchers conclude.

Reference:

"Simultaneous Intratympanic Use of Gentamicin and Dexamethasone in Meniere's Disease: Randomized Controlled Study" was presented at the AAO-HNSF 2022 Annual Meeting & OTO Experience.