Hearing Loss Following Intratympanic Instillation of Gentamicin for the Treatment of Unilateral Meniere's Disease
Bibliographic record
Abstract
OBJECTIVE: To determine the incidence, extent, and time course of hearing loss following instillation of intratympanic gentamicin using a predetermined fixed protocol for incapacitating unilateral Meniere's disease and to determine whether such loss is associated with any identifiable risk factors. STUDY DESIGN: A retrospective analysis of all patients treated with intratympanic gentamicin between 1988 and 1998 using American Academy of Otolaryngology-Head and Neck Surgery reporting guidelines (1985 and 1995). A predetermined regimen using a fixed dose (gentamicin 26.7 mg/mL administered three times daily for 4 consecutive days) was used. METHODS: The records of patients treated with this particular protocol were reviewed. The relationship between pretreatment hearing acuity, pretreatment bithermal caloric response, duration of symptoms, and previous treatment to post-treatment hearing were analyzed with respect to hearing. RESULTS: Complete vestibular and audiologic data over a minimum 2-year follow-up were available for 85 individuals. Sixty-three patients (74.1%) had unchanged or improved hearing, and 22 patients (25.9%) realized hearing loss. In 80% of the latter, it occurred during the first month post-treatment. When hearing acuity at the 1-month post-treatment interval remained unchanged (91.1%), it was likely to remain so over the next 23 months. A significantly higher incidence of profound hearing loss was noted in patients who developed hearing loss in the first month, as compared with those who developed hearing loss at a later period (p = .0207, relative risk = 1.5). Re-treatment was not associated with hearing loss. The only identifiable risk factor for developing hearing loss was pretreatment hearing acuity stages 3 and 4 (pure-tone average > 40 dB) (p = .022, relative risk = 1.5). CONCLUSION: Hearing loss is a recognized complication of treatment with intratympanic gentamicin, occurring in approximately 26% of individuals. In those individuals in whom hearing acuity has remained unchanged after the first month interval, significant worsening of hearing is unlikely, and patients can be reassured accordingly.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".