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Long-term follow-up of intratympanic methylprednisolone versus gentamicin in patients with unilateral Menière’s disease
Harcourt, Jonny P. Lambert, Aileen Wong, Phui Yee Patel, Mitesh Agarwal, Kiran Golding, John F. Bronstein, Adolfo M.
Harcourt, Jonny P.
Lambert, Aileen
Wong, Phui Yee
Patel, Mitesh
Agarwal, Kiran
Golding, John F.
Bronstein, Adolfo M.
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2019-02-14
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Abstract
Objectives: To determine whether long term (>48 months) symptomatic vertigo control is sustained in patients with Menière’s disease from a previous comparative trial of intratympanic methylprednisolone versus gentamicin, and if the two treatments remain nonsignificantly different at longterm follow-up. Study Design: Mail survey recording vertigo frequency in the previous one and six months, further intratympanic treatment received, and validated symptom questionnaires. Setting: Outpatient hospital clinic setting. Patients: Adult patients with definite unilateral refractory Menie`re’s disease, who previously received in tratympanic treatment in a comparative trial. Intervention: A survey of trial participants who received intratympanic gentamicin (40 mg/mL) or methylprednisolone (62.5 mg/mL). Outcome measures: Primary: number of vertigo attacks in the 6 months prior to receiving this survey compared with the 6 months before the first trial injection. Secondary: : Number of vertigo attacks over the previous 1 month; validated symptom questionnaire scores of tinnitus, dizziness, vertigo, aural fullness, and functional disability. Results: Average follow-up was 70.8 months (standard deviation 17.0) from the first treatment injection. Vertigo attacks in the 6 months prior to receiving the current survey reduced by 95% compared to baseline in both drug groups (intention-to-treat analysis, both p<0.001). No significant difference between drugs was found for the primary and secondary outcomes. Eight participants (methylprednisolone ¼ 5 and gentamicin ¼ 3) required further injections for relapse after completing the original trial. Conclusion: Intratympanic methylprednisolone treatment provides effective long-lasting relief of vertigo, without the known inner-ear toxicity associated with gentamicin. There are no significant differences between the two treatments at long term follow-up.
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Harcourt, J.P., Lambert, A., Wong, P.Y., Patel, M., Agarwal, K., Golding, J.F. and Bronstein, A.M. (2019) 'Long-term follow-up of intratympanic methylprednisolone versus gentamicin in patients with unilateral Menière’s disease', Otology & Neurotology. 40 (4), pp. 491-496. doi:10.1097/MAO.0000000000002108
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Journal article
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en
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1531-7129
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Attribution-NonCommercial-NoDerivs 3.0 United States