Would Someone Explain Gent Injections?

Discussion in 'Your Living Room' started by Aladdin, Jun 9, 2007.

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  1. Aladdin

    Aladdin Guest

    I think I understand but what does it specifically do for mm/vertigo? ???
     
  2. Bergie

    Bergie New Member

    T..lots of info in our Database here. I looked for you, this site is pretty good. Hope it helps explain:

    http://www.dizziness-and-balance.com/disorders/menieres/menieres.html#surgery
     
  3. Linda1002

    Linda1002 New Member

    Summary of that article:

    It manages vertigo.
     
  4. Aladdin

    Aladdin Guest

    thanks
    xoxo
     
  5. It helped me twice and didn't help the third or fourth time--by then I was well on my way to near total hearing loss in the affected ear.

    It's worth a shot (if you will pardon the pun), it was far less obnoxious than prednisone (shudder).
     
  6. LisaB

    LisaB New Member

    I have had 7 shots since January, the current theory being shots of not super high strength and have many over time until you reach a point where you feel sick (because you are destroying the hair cells in the ear picking up the erroneous signals) and then your body adjusts to the loss of the balance that has been destroyed in your ear. The hope is to end the vertigo. Gent can cause hearing loss and imbalance. For me, I felt better after the first shot, but the doc has been pretty directed on how far to go.....at first we stopped because I felt SO good, but then when I had very minor symptoms again he said we needed to go on a regimen of regular shots a few weeks apart. I just continue to feel better and better, with the 5th shot causing the desired for not so feeling great for a week. I had the last few because he says some of my symptoms were the wrong kind to still have, he asks me lots of questions of how I'm feeling. The difference in my life from last year to this is ....phenomenal. No imbalance, my hearing fluctuates from what it was to better, and my energy is BACK. So I very much hope that it will be a long term solution, but we shall see. I don't have great hearing in that ear so that made this course of treatment easier to decide. Over the last few years my symptoms had worsened greatly in severity and I am currently very glad I made this decision. Lisa
     
  7. twinklenani

    twinklenani Guest

    I had two shots...2 weeks apart and I had 22 months of "normalcy". It was wonderful, but my doctor wouldn't give me anymore because he said it could cause more problems? I am having a really rough day today and wish someome would try this again, but I haven't found another doctor who will give me anymore shots...thank God for valium! Blessings, twinkle
     
  8. Aladdin

    Aladdin Guest

    xoxoxox

    i am only getting them in the left ear as mm is highly noted there once i manage the shot i will be undergoing a different approach - masteoid(sp) to help control vertigo in right ear for superior canal

    vertigo is my main object at this moment - the rest i can manage

    oxo
     
  9. Dizzy Little Piggy

    Dizzy Little Piggy OINK OINK

    Just be careful because even though the Gent injections are less evasive than surgery, they can cause hearing loss and excell the pace of your hearing loss in the treated ear.

    Piggy
     
  10. LisaB

    LisaB New Member

    Twinkle, from the extensive reading I have done, sometimes the hair cells grow back and you need a "refresher" on the gent. It says it's not uncommon. My doc mentioned this also. I am surprised your doc will not do more. Just from the research I have done, FYI. Do they say why they won't do more? Lisa B.
     
  11. Aladdin

    Aladdin Guest


    piggy - does this make sense - but i would rather lose hearing in ear than vertigo - i know hearing loss is hard but vertigo daily is almost unbearable but i have noise induced vertigo
    xoxox
     
  12. LisaB

    LisaB New Member

    It does make sense, of course. It's just good to be prepared for it to be a possiblity. Also, if you are willing to lose hearing, in my opinion it is time to do gent. Everyone reaches this point at their own time, and with their own symptoms, although hopefully not everyone will get this desperate with their symptoms. Lisa
     
  13. LisaB

    LisaB New Member

    This is from menieresinfo.com. I thought it presented different points of view about how to admin gent....kinda interesting.

    Gentamicin ("gent").
    Like streptomycin (above), gentamicin is an antibiotic, and it is also ototoxic, although less ototoxic than streptomycin.
    There are three possible reasons for intratympanic instillation of gentamicin.
    1. To destroy the "dark cells" that produce endolymph, with the objective of reducing the production of endolymph, thus reducing the "hydrops." If this is the reason, the hope is that the tiny hairs in the vestibule (which affect the balance function) and the tiny hairs in the cochlea (which affect the hearing function) will be undamaged, or at least not damaged very much. This is usually a very low dose (in terms of volume and strength) of gentamicin. There may be one or more injections, and the length of time (interval) between multiple injections may vary.
    2. To damage the tiny hairs in the vestibule with the objective of impairing the transmission of faulty vestibular (balance) data to the brain. If this is the reason, the hope is that the tiny hairs in the cochlea will be undamaged, or at least not damaged much, because damage to the tiny hairs in the cochlea causes hearing loss. There may be one or more injections, and the length of time between multiple injections may vary. This is usually a somewhat higher dose of gentamicin that is given for purpose 1 above, but still a low enough dose to attempt to preserve whatever hearing may remain.
    3. To ablate (destroy) the labyrinth totally, using a high dose of gentamicin, with the objective of totally destroying the tiny hairs in the vestibule to block all transmission of vestibular (balance) data to the brain, and accepting the concurrent destruction of the tiny hairs in the cochlea, which will cause deafness. This high dose of gentamicin is usually (but not always) performed when there is little or no functional hearing left. This is called a "chemical labyrinthectomy," because the effect is to totally destroy all functions of the labyrinth, both vestibular and cochlear. Streptomycin (see above) could be used for this purpose instead of gentamicin. An alternative would be a "surgical" labyrinthectomy, in which the organs of the labyrinth are surgically removed.
    There are different "protocols" for each of the methodologies above, depending on the patient and on the doctor. The strength of the gentamicin and the interval between the instillations may vary.
    University of Pittsburgh Medical Center.
    Click here to search PubMed for Meniere's Disease and gentamicin/gentamycin.
    August 25, 2005 -- A study on the use of intratympanic gentamicin to treat Meniere's Disease has been added to PubMed: Long-term results of the transtympanic (intratympanic) gentamicin treatment in Meniere's disease. The affiliation of the authors is the Clinic of Otolaryngology in Warsaw, and the article is in Polish. According to the abstract, nine patients were followed for 24 months, of whom all nine achieved complete control of vertigo, while hearing was improved in six patients, unchanged in two patients, and profoundly lost in "only" one patient.
    Comment: We believe that "only" one out of nine patients deafened represents a serious risk. It seems to us that key to the outcome of intratympanic gentamicin treatment is the protocol used: the strength of the gentamicin, the quantity instilled, and the interval between instillations. We believe that a good analysis of such studies can only be made having the specific protocols at hand. We recommend that a patient considering intratympanic gentamicin treatment ask one's doctor for the protocol contemplated and for the studies using that protocol upon which that doctor is relying in selecting it. (Then sit back in your chair and watch the reaction.)
     
  14. Aladdin

    Aladdin Guest

    lisa /piggy - all - if the gent will destroy cells and some hearing in referance to balance - in my left ear where mm is residing and ruling - my hearing is worse for left ear anyways if i lose hearing which helps minimize vertigo - i still have the right ear that is not as affected by mm but SCDS and noise and pressure cause vertigo - with that thought the surgeon is going to drill and fill hole in temporal lobes - but do ya'll think a gent injection would or could be affective in the right hear - if hearing causes vertigo and a gent destroys some hearing and balance - could that help - ? not the pressure part but noise induced - also the surgery alone will destroy a said amount of low decimal hearing anyways - i'm kicking this around - what do you think?

    xoxo
     
  15. LisaB

    LisaB New Member

    Hi Aladdin, I have never heard that hearing causes vertigo. Not sure about that one. The fluid, or hydrops does, right? I think gent can help in many situations, and unfortunately probalby only can be evaluated by your doc. (or fortunately. :)) I find it very interesting that gent can improve hearing....before I really researched this I had never heard this. I went in planning on a strong possiblity that my hearing would worsen, which is how I think you have to realistically be prepared. But so many people's doesn't worsen. At least that's hope. I think one major problem with doing gent in both ears is that you can't lose balance completely on both sides....or at least a doc wouldn't induce that. It's also why you can't have VNS or laby done on both sides. One thing about treating only one ear is the balance on the other side can take over and compensate. But- ask your doc for more information. Lisa
     
  16. Verti_Geaux

    Verti_Geaux New Member

    Did you have bad reactions to Prednisone? I was on that and I LOVED IT! It made me feel so good I thought I could conquer the world. Was on it for one week b/c Mar. & Apr. was so bad! Started those on May 3, then when they ran out doc put me on low does of methyprednisolone to tide me over until my surgery on Tues. I haven't had any side effects that I know of. It's helped me "live" and gave me energy galore. Plus NO ATTACKS since I've been on them! Yea!!! Just wondering how others did with steriods?
    Anne-Marie
     
  17. twinklenani

    twinklenani Guest

    Bergie, thanks for that website! Blessings, twinkle
     
  18. LisaB

    LisaB New Member

    I did very well on steroids, no negative side effects (if I came off them slowly, important), but then they slowly stopped their effectiveness. Everyone reacts differently. Lisa
     
  19. Aladdin

    Aladdin Guest

    http://www.otosurgery.org/sscd.htm

    noise/pressure induced vertigo
    also

    tullios

    http://www.dizziness-and-balance.com/disorders/symptoms/tullio.html

    amesyth suffers from this as well
     
  20. Aladdin

    Aladdin Guest

    Hi Aladdin, I have never heard that hearing causes vertigo. Not sure about that one.

    superior semicircular canal dehiscence (SSCD)

    definition of SSCD

    Lloyd Minor, MD, was the first to describe this syndrome in 1998. It usually affects men more commonly than women in their 30s to 40s. Patients often complain of dizziness and vertigo usually triggered by straining, heavy lifting, or loud, usually low frequency sounds. Other common complaints include fullness in the ear(s), autophony (an echo or reverberation of the ear when speaking, chewing, or swallowing), or hearing loss. Some complain that they can hear their own heartbeat in the affected ear.

    Patients with SSCD can have dizziness and/or hearing loss. In most cases, a blocked or fullness sensation of the ear is fairly consistent across most patients with SSCD. Some SSCD patients only have fullness or hearing loss. Dizziness is NOT seen in all patients with SSCD.

    what is the problem in SSCD?

    The superior semicircular canal is one of three paired canals which in part, comprise the balance organs of the inner ear. The superior (also called the anterior), posterior, and horizontal semicircular canals sense head movements, stabilizing eye movements in response to angular acceleration.

    The defect is a small hole in the inner ear bone, measuring less than 1mm to up to 5mm in size, of the superior semicircular canal. SSCD appears to be more common on the left side, but can be seen on the right side, or on both sides. Often, the skull base surrounding the SSCD is also very thin or perforated.

    In autopsy specimens, examination of temporal bones, the region of the skull base which houses the inner ear - the cochlear and the vestibular organs, including the semicircular canals - reveal that 2% have abnormal thinning or breakdown (dehiscence) of the superior semicircular canals. It is felt to be a developmental abnormality. It is rare for SSCD to present early in life - most patients are diagnosed in their 30s to 40s. However, only recently have otolaryngologists become aware of this condition and, with improvements in diagnostic methods (especially audiologic and radiologic) we would expect that more patients will be diagnosed with this condition at earlier ages.

    In a meta-analysis by Watters et al 53% of patients with SSCD who needed surgery had the condition on the left, 23% on the right, and 23% were bilateral (both sides)
     

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