Transtympanic gentamicin treatment using Silverstein MicroWick in Meniere's disease patients: long term outcome

Objective: To assess the long term outcome of gentamicin inner-ear perfusion using the Silverstein MicroWick (TM) in the treatment of Meniere's disease. Study design: Retrospective questionnaire survey of patients and review of medical records. Setting: A district general hospital. Participants: All 15 patients who completed a minimum follow Lip of at least 24 months were included. Main outcome measures: Subjective symptoms, change in hearing thresholds and Glasgow benefit inventory scores. Results: Based on the American Association of Otolaryngology-Head and Neck Surgery (1995) guidelines for reporting, 80 per cent of respondents obtained class A vertigo control and 20 per cent obtained class B control. Respondents' functional level improved from pre-operative levels of between three and six to post-operative levels of between one and three. Three respondents had pre-operative 'dead ears' and one developed the condition post-operatively. Hearing deteriorated further in three respondents, improved in two and remained unchanged in the rest. Respondents with class A control demonstrated improved quality of life, with a mean Glasgow benefit inventory total score of +34. Conclusion: Transtympanic gentamicin therapy via the Silverstein MicroWick results in good vertigo control. Patients should however be made fully aware of the risk of hearing deterioration.