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首页> 外文期刊>The Journal of otolaryngology >Hearing loss following intratympanic instillation of gentamicin for the treatment of unilateral Meniere's disease.
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Hearing loss following intratympanic instillation of gentamicin for the treatment of unilateral Meniere's disease.

机译：鼓膜内滴注庆大霉素治疗单侧美尼尔氏病后的听力损失。

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OBJECTIVE: To determine the incidence, extent, and time course of hearing loss following instillation of intratympanic gentamicin using a predetermined fixed protocol for incapacitating unilateral Meniere's disease and to determine whether such loss is associated with any identifiable risk factors. STUDY DESIGN: A retrospective analysis of all patients treated with intratympanic gentamicin between 1988 and 1998 using American Academy of Otolaryngology-Head and Neck Surgery reporting guidelines (1985 and 1995). A predetermined regimen using a fixed dose (gentamicin 26.7 mg/mL administered three times daily for 4 consecutive days) was used. METHODS: The records of patients treated with this particular protocol were reviewed. The relationship between pretreatment hearing acuity, pretreatment bithermal caloric response, duration of symptoms, and previous treatment to post-treatment hearing were analyzed with respect to hearing. RESULTS: Complete vestibular and audiologic data over a minimum 2-year follow-up were available for 85 individuals. Sixty-three patients (74.1%) had unchanged or improved hearing, and 22 patients (25.9%) realized hearing loss. In 80% of the latter, it occurred during the first month post-treatment. When hearing acuity at the 1-month post-treatment interval remained unchanged (91.1%), it was likely to remain so over the next 23 months. A significantly higher incidence of profound hearing loss was noted in patients who developed hearing loss in the first month, as compared with those who developed hearing loss at a later period (p = .0207, relative risk = 1.5). Re-treatment was not associated with hearing loss. The only identifiable risk factor for developing hearing loss was pretreatment hearing acuity stages 3 and 4 (pure-tone average > 40 dB) (p = .022, relative risk = 1.5). CONCLUSION: Hearing loss is a recognized complication of treatment with intratympanic gentamicin, occurring in approximately 26% of individuals. In those individuals in whom hearing acuity has remained unchanged after the first month interval, significant worsening of hearing is unlikely, and patients can be reassured accordingly.
机译：目的：使用预先确定的固定方案使单侧美尼尔氏病致残，确定滴注鼓室内庆大霉素后听力丧失的发生率，程度和时间过程，并确定这种丧失是否与任何可识别的危险因素有关。研究设计：使用美国耳鼻咽喉头颈外科学院报告指南（1985年和1995年），对1988年至1998年期间接受鼓膜内庆大霉素治疗的所有患者进行回顾性分析。使用使用固定剂量的预定方案（庆大霉素26.7 mg / mL，连续3天每天3次给药）。方法：回顾了接受该特定方案治疗的患者的记录。就听力而言，分析了治疗前听觉敏锐度，治疗前双热热量反应，症状持续时间和治疗前对治疗后听力之间的关系。结果：至少2年的随访中，有85位患者获得了完整的前庭和听力学数据。六十三名患者（74.1％）的听力保持不变或有所改善，而22名患者（25.9％）出现了听力下降。在后者的80％中，它发生在治疗后的第一个月。当治疗后1个月的间隔时间的听力保持不变（91.1％）时，在接下来的23个月中可能会保持不变。与在较晚时期出现听力损失的患者相比，在第一个月出现听力损失的患者中发现严重听力损失的发生率明显更高（p = .0207，相对危险度= 1.5）。再治疗与听力损失无关。发生听力损失的唯一可确定的危险因素是治疗前的听力敏锐度第3和第4阶段（纯音平均值> 40 dB）（p = .022，相对危险度= 1.5）。结论：听力减退是公认的鼓膜内庆大霉素治疗并发症，约26％的个体发生。在第一个月间隔后听力保持不变的那些人中，听力的严重恶化不太可能发生，因此可以使患者放心。

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