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. |
