TRANSTYMPANIC PERFUSION THERAPY IN TREATMENT OF MENIERE'S DISEASE
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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.