Méniére's Disease Vertigo Persisting After Intratympanic Gentamicin Injection
This protocol targets patients with active Méniére's disease whose vertigo attacks were not adequately reduced or controlled following intratympanic gentamicin injection. When that prior step does not achieve sufficient control, a more definitive next-line intervention may be considered.
Previous treatment — goal not achieved
Intratympanic gentamicin injection was the preceding treatment step. Its intended goal was reduction or control of Méniére's disease vertigo attacks. Non-achievement of that goal is the trigger for escalation to this protocol.
Next-line approach — partial overview
The next step involves a definitive surgical procedure directed at the affected ear, applicable only in patients with nonusable hearing on that side. The clinical goal is complete control or resolution of vertigo attacks. Full eligibility criteria, procedural details, and the structured regimen are available via the link below.
References
DOI: 10.1177/0194599820909438
- Clinicians may offer, or refer to a clinician who may offer, labyrinthectomy in patients with active Ménière's disease who have failed less definitive therapy and have nonusable hearing.
- Labyrinthectomy, most commonly performed via a transmastoid approach, is a definitive surgical procedure that attempts to abolish abnormal vestibular input in a diseased ear.
- The goal of labyrinthectomy is to completely remove the abnormal sensory neuroepithelial elements of the semicircular canals and otolith organs that are believed to cause vertigo episodes in MD patients.
- The goals of MD treatment are to prevent or at least reduce the severity and frequency of vertigo attacks.
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