Intractable vertigo in Meniere's Disease still presents a challenging sit
uation for the otolaryngologist As there is no established treatment which
is universally agreed upon, the debate is still going on. Transtympanic
topical drugs application through a ventilation tube is both practical and
easy. The medication easily reaches middle ear through the ventilation
tube where it can be absorbed through the round window. The tube is
placed in the lower posterior quadrant of the tympanic membrane to pro
mote the diffusion through the round window. The advantages of this ad
ministration route include: no systemic side effects and it can be easily
performed under local anaesthesia. In this investigation, transtympanic
perfiision with gentamycin was applied in nine patients and with dexamethasone
in another nine. Satisfactory control of vertigo was achieved
in 77.8% and 55.8% respectively for the two modalities. In gentamycin
group, hearing level showed marked deterioration in one patient and re
mained the same in 8 patients. In the dexamethasone group, hearing lev
el remained the same in 6 patients and improved in 3 patients.This
shows that transtympanic perfusion therapy can be a good alternative to
an intracranial surgery which is difficult for an ordinary ENT surgeon to
perform. |
