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Effect of Intratympanic Chemical Labyrinthectomy with Streptomycin on Auditory Symptoms
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Hyun Su Kim, Sung Huhn Kim, Dae Bo Shim, Sang Cheol Kim, Won Sun Yang
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Res Vestib Sci. 2009;8(1):32-36.
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 Abstract
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- Background and Objectives Background and Objectives: Intratympanic treatment with aminoglycosides for Ménière’s disease has been used, trying to eliminate vertigo complaints, while preserving hearing. This study was undertaken to evaluate the therapeutic outcomes for auditory symptoms in Ménière’s disease patients after intratympanic application with single low-dose streptomycin powder.
Materials and Methods Ninty-eight patients diagnosed with definite Ménière’s disease who underwent chemical labyrinthectomy with streptomycin at Yonsei University Medical Center from March 1997 to June 2006 were enrolled. Low dose streptomycin powder (10 mg) was applied into the round window niche directly. Changes of hearing threshold, tinnitus and aural fullness were evaluated postoperatively according to Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Ménière’s disease of American Academy of Otolaryngology–Head and Neck Surgery.
Results Hearing threshold was not changed significantly after the procedure (from 65.5±19.1 to 69.3±20.0 p>0.05) and was improved in 7% of the patients. Hearing deterioration after the procedure was detected only in 17%. Tinnitus and aural fullness was improved in 51% and 25% respectively.
Conclusion Single application of streptomycin powder filling round window niche showed minimal deterioration of hearing threshold. It is the useful method to improve or prevent the progress of auditory symptoms in patients with Ménière’s disease.
Key Words: Streptomycin; Hearing loss; Tinnitus; Meniere Disease; Aural fullness
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Clinical Significance of Vestibular Evoked Myogenic Potentials in Patients With Benign Paroxysmal Positional Vertigo
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Won Sun Yang, Dae Bo Shim, Won Sang Lee
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J Korean Bal Soc. 2008;7(1):38-42.
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Abstract
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- Objectives: To investigate the vestibular evoked myogenic potentials (VEMP) results in benign paroxysmal positional vertigo (BPPV) patients and to verify its clinical applications in BPPV.
Subjects and Methods: Forty-one patients with diagnosis of BPPV and 92 healthy volunteers who underwent VEMP testing. Patients were treated by canalith repositioning maneuvers according to the affected canal, and testing of VEMP was performed at diagnosis and after treatment.
Results: VEMP results of BPPV patients showed prolonged p13 and n23 latencies compared with those of the control group, and we could not find any significant difference in VEMP latencies between patients with posterior and horizontal canal type of BPPV. The number of times that the maneuver was repeated did not correlate with the degree of latency prolongation, but in the “no response” group, the number of times was considerably greater than those in the “response” group.
Conclusions: We found that VEMP latencies are increased in BPPV patients, which may signify neuronal degenerative changes in the macula of the saccule. When an extensive neuronal damage was suspected by VEMP results such as “no response” in VEMP, the disease progress showed a chronic and resistive course. Therefore, we propose that VEMP could be a useful method to determine a clinical prognosis of patients with BPPV.
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