TRANSTYMPANIC PERFUSION THERAPY IN TREATMENT OF MEMERE" S DISEASE
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Intractable vertigo in Meniere's Disease still presents a challenging situation 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 promote the diffusion through the round window. The advantages of this administration route include: no systemic side effects and it can be easily performed under local anaesthesia. In this investigation. transtympartic perfusion with gentamycin was applied in nine patients and with dexamethasone in another nine. Satisfactory control of vertigo was achieved in 77.8% and 55.6% respectively for the two modalities. In gentarnycin group, hearing level showed marked deterioration in one patient and remained the same in 8 patients. In the dexarnethasone group, hearing level remained the same in 6 patients and improved in 3 patients.This shows that transtympanic perfusion therapy can be a good alternative to an irttracranial surgery which is difficult for an ordinary ElVT surgeon to perform.