{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:35:56Z","timestamp":1761006956535,"version":"build-2065373602"},"reference-count":20,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2016,5,17]],"date-time":"2016-05-17T00:00:00Z","timestamp":1463443200000},"content-version":"vor","delay-in-days":3820,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2005,12]]},"abstract":"<jats:sec><jats:title>OBJECTIVE<\/jats:title><jats:p>To determine the effects of transtympanic injections, with a mixture composed of gentamicin and fibrin tissue adhesive (FTA), on vestibular function of patients with intractable unilateral Meni\u00e8re's disease.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN<\/jats:title><jats:p>This was an open, prospective study.<\/jats:p><\/jats:sec><jats:sec><jats:title>SETTING AND PATIENTS<\/jats:title><jats:p>The study was performed at 2 tertiary referral centers. Twenty\u2010six patients affected by \u201cdefinite\u201d unilateral Meni\u00e8re's disease, unresponsive to medical therapy for at least 6\u00a0months, were enrolled.<\/jats:p><\/jats:sec><jats:sec><jats:title>INTERVENTION<\/jats:title><jats:p>A buffered gentamicin solution mixed with FTA was injected in the middle ear until the development of bedside vestibular hypofunction signs and\/or caloric weakness in the treated ear.<\/jats:p><\/jats:sec><jats:sec><jats:title>MAIN OUTCOME MEASURE<\/jats:title><jats:p>Vestibular function was evaluated by 3 bedside vestibular tests (observation of spontaneous nystagmus, head shaking test, and head thrust test) and by a caloric test. Tests were performed on days 10 and 30 after completion of treatment. Tests were also performed 3, 6, and 12\u00a0months from completion of the gentamicin\u2010FTA protocol. The effects of treatment were also assessed in terms of hearing levels, control of vertigo, and disability status.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS<\/jats:title><jats:p>In 22 of the 26 patients, only 1 gentamicin\u2010FTA injection was necessary to obtain 1 or more signs indicating a reduction of the vestibular function in the treated ear. Four patients needed another treatment because of the persistence of their incapacitating symptoms during the follow\u2010up. Four patients needed more than 1\u00a0injection to obtain a vestibular hypofunction. None of the patients who received 1 or 2\u00a0injections presented hearing loss in direct temporal relationship to the treatment.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>A mixture of gentamicin and fibrin glue makes it possible to considerably reduce the number of administrations in patients with intractable unilateral Meni\u00e8re's disease. Spontaneous nystagmus, post head shaking nystagmus, and a head thrust sign are the clinical signs that indicate onset or progression of unilateral vestibular hypofunction. These signs were obtained with only 1\u00a0injection in 81% of patients.<\/jats:p><\/jats:sec><jats:sec><jats:title>EBM RATING<\/jats:title><jats:p>C<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.otohns.2005.07.033","type":"journal-article","created":{"date-parts":[[2005,12,20]],"date-time":"2005-12-20T10:21:35Z","timestamp":1135074095000},"page":"929-935","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Transtympanic Gentamicin and Fibrin Tissue Adhesive for Treatment of Unilateral Meni\u00e8re's Disease: Effects on Vestibular Function"],"prefix":"10.1002","volume":"133","author":[{"given":"Augusto","family":"Casani","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology University of Pisa Pisa Italy"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniele","family":"Nuti","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology University of Siena Siena 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