Role of prior intratympanic gentamicin and corticosteroids therapy on speech understanding in patients with Menière's disease after cochlear implantation

Eur Arch Otorhinolaryngol. 2024 Jul;281(7):3483-3490. doi: 10.1007/s00405-024-08449-8. Epub 2024 Feb 2.

Abstract

Aim: Intratympanic injection of corticosteroids (ITC) and gentamicin therapy (ITG) are widely used treatments for vertigo in Meniere's disease (MD). Even though studies show good results after cochlea implantation (CI) in MD patients when compared to non-MD groups, there is no indication on the effect of ITC and ITG prior to CI on hearing after CI. This study compares the post-operative hearing of CI patients with and without MD and patients who have received ITG or ITC prior to CI.

Methods: In a retrospective case control study, adult patients with MD who received CI from 2002 till 2021 were compared to a matched control group of CI patients without MD. Patients with prior ITC/ITG were extracted from MD group. Pre-operative audiological results were measured and trends across post-operative monosyllabic word recognition score at 65 decibels (WRS65CI) at switch-on, 3-6 months, 1 year and last yearly value were analyzed across all groups.

Results: 28 MD ears were compared with 33 control ears. From MD ears 9 had received ITG and 6 ITC prior to CI. WRS65CI increased significantly with time within MD and control groups, but no difference in WRS65CI was found between these 2 groups. ITG ears showed fluctuating WRS65CI after CI with no change across time, while ITC ears showed significant increase in trend of WRS65CI values across time.

Conclusion: MD and non-MD patients showed comparable hearing results after CI. Prior ITC might positively influence hearing preservation after CI in MD patients whereas ITG group showed fluctuating hearing.

Keywords: Cochlear implantation; Intratympanic corticosteroids; Intratympanic gentamicin; Meniere’s disease; Post-operative hearing.

MeSH terms

  • Adrenal Cortex Hormones / administration & dosage
  • Adrenal Cortex Hormones / therapeutic use
  • Adult
  • Aged
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Case-Control Studies
  • Cochlear Implantation*
  • Female
  • Gentamicins* / administration & dosage
  • Gentamicins* / therapeutic use
  • Glucocorticoids / administration & dosage
  • Glucocorticoids / therapeutic use
  • Humans
  • Injection, Intratympanic*
  • Male
  • Meniere Disease* / drug therapy
  • Middle Aged
  • Retrospective Studies
  • Speech Perception*
  • Treatment Outcome

Substances

  • Gentamicins
  • Glucocorticoids
  • Anti-Bacterial Agents
  • Adrenal Cortex Hormones