Post-operative Hearing and the role of intratympanic gentamicin therapy in patients with Menière's disease after Cochlear implantation

Introduction For patients with Menière's disease (MD) and severe to profound hearing loss a good post-operative hearing outcome after cochlear implantation (CI) has been reported by some authors. No information is available on post-CI hearing of patients who initially underwent ablative therapy with gentamicin. We aim to compare the post-operative speech understanding of patients who received CI with and without MD and who received ablative gentamicin therapy pre-operatively.

Methods Retrospective case-control study comparing adults with and without MD including prior gentamicin therapy who received CI (2002 till 2020). We examined the preoperative pure tone audiogram, unaided and aided speech audiogram before CI and compared with post-CI speech audiograms.

Results 26 adults with MD received unilateral CI (mean 57.1±15.4 years). 7 of 26 (27%) patients received gentamicin. Another 26 patients from the same CI databank, who did not have MD, were matched with the MD patients based on age, level of hearing loss and duration of deafness. 

At 1-month follow-up the gentamicin group performed better in monosyllabic speech test at 65dB as follows: MD group  = 46%, MD with gentamicin = 49%, Control group=40%. But the control group outperformed the MD group at 1-year testing: MD group  = 58%, MD with gentamicin = 60%, Controls  = 66%. The control group continued to perform better thereafter while the MD group showed a minimal regression of their Results MD group  = 56%, MD with gentamicin = 56%, Controls  = 68%

Conclusion Speech understanding scores significantly improved after CI in patients with MD with similar results as with non-MD patients and prior gentamicin therapy playing no role. However, our data hint at a degradation in speech understanding over time in MD patients.

Katrin Reimann

Publication History

Article published online:
24 May 2022