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• W3048985359 abstract "In Reply: We would like to thank the authors of the letter to the editor for their response to our recently published article entitled, “Intratympanic Treatment in Menière's Disease, Efficacy of Aminoglycosides Versus Corticosteroids in Comparison Studies: A Systematic Review” (1). We also would like to thank the authors for the additional information regarding the importance of the optimal dietary management of Menière's disease (MD) concerning the possible role played by hyperinsulinemia in subjects affected by MD (2), and their view on treatment of MD by intratympanic gentamicin (ITG) (3). Indeed, to relieve symptoms many lifestyle and dietary adjustments like reducing salt and caffeine intake, and the role of glucose have been suggested by many (4–6). However, in the clinic these treatment methods seem not to decrease the frequency or intensity of the attacks in the initial phase of the disease (7). Therefore, ITG and intratympanic corticosteroids are necessary and in good use to decrease the frequency and intensity of vertigo attacks. Similar to the findings in our review, Scarpa et al. (3) treated 48 patients with unilateral MD successfully with low dose of ITG decreasing the vertigo attacks. Aminoglycosides seem to be more effective in symptom control of vertigo attacks in comparison with corticosteroids, where corticosteroids have a lower risk of hearing damage (1). However, the findings in our review showed the difference in hearing loss diminished over time between ITC and ITG (1). Although there is no current consensus on clinical guidelines for the use of gentamicin in terms of dose and duration, our review also suggests preferring low-dose protocols to minimize hearing deterioration (1). As mentioned in our review, we hypothesize that ITG might in some patients, during a short period of time after treatment, result in a reversible damage to the inner ear hair cells, which restores thereafter. This might be a manifestation of the regenerative capacity of the inner ear, though this ability seems to be limited in correlation with the amount of exposure (1). Future research will be necessary to make more consistent evidence-based statement regarding the development of a proper treatment protocol in terms of dose and duration." @default.
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• W3048985359 date "2020-09-01" @default.
• W3048985359 modified "2023-09-26" @default.
• W3048985359 title "Response to Letter to the Editor: “Effectiveness of Intratympanic Administration of Gentamicin in Unilateral meniÈre's Disease”" @default.
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• W3048985359 doi "https://doi.org/10.1097/mao.0000000000002817" @default.
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