Objectives: To determine whether long term (>48 months)
symptomatic vertigo control is sustained in patients with
Menie`re’s disease from a previous comparative trial of
intratympanic methylprednisolone versus gentamicin, and if the two treatments remain nonsignificantly different at longterm follow-up.
Study Design: Mail survey recording vertigo frequency in
the previous one and six months, further intratympanic
treatment received, and validated symptom questionnaires.
Setting: Outpatient hospital clinic setting.
Patients: Adult patients with definite unilateral refractory Menie`re’s disease, who previously received in tratympanic treatment in a comparative trial.
Intervention: A survey of trial participants who received
intratympanic gentamicin (40 mg/mL) or methylprednisolone
Outcome measures: Primary: number of vertigo attacks in
the 6 months prior to receiving this survey compared with
the 6 months before the first trial injection.
Secondary: : Number of vertigo attacks over the previous 1 month; validated symptom questionnaire scores of tinnitus, dizziness, vertigo, aural fullness, and functional disability.
Results: Average follow-up was 70.8 months (standard
deviation 17.0) from the first treatment injection. Vertigo attacks in the 6 months prior to receiving the current survey reduced by 95% compared to baseline in both drug groups (intention-to-treat analysis, both p<0.001). No significant difference between drugs was found for the primary and secondary outcomes. Eight participants (methylprednisolone ¼ 5 and gentamicin ¼ 3) required further injections for relapse after completing the original trial.
Conclusion: Intratympanic methylprednisolone treatment provides effective long-lasting relief of vertigo, without the known inner-ear toxicity associated with gentamicin. There are no significant differences between the two treatments at long term follow-up.