The use of intratympanic gentamicin in patients with vestibular schwannoma and disabling vertigo

• Published in: Otology & neurotology Vol. 34; no. 6; p. 1096
• Main Authors: Giannuzzi, Anna Lisa, Merkus, Paul, Falcioni, Maurizio
• Format: Journal Article
• Language: English
• Published: United States 01.08.2013
• Subjects: Aged; Aged, 80 and over; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Audiometry, Pure-Tone; Caloric Tests; Female; Gentamicins - administration & dosage; Gentamicins - therapeutic use; Humans; Microinjections; Neuroma, Acoustic - complications; Neuroma, Acoustic - drug therapy; Neuroma, Acoustic - pathology; Nystagmus, Physiologic; Otologic Surgical Procedures; Round Window, Ear; Speech Discrimination Tests; Treatment Outcome; Tympanic Membrane; Vertigo - drug therapy; Vertigo - etiology
• ISSN: 1537-4505
• DOI: 10.1097/MAO.0b013e3182804c41

To document the effect of intratympanic gentamicin as treatment of disabling vertigo secondary to a vestibular schwannoma in elderly patients. Four elderly patients with a vestibular schwannoma, with an extrameatal diameter of less than 1 cm, experiencing disabling vertigo and followed a wait-and-scan policy. Intratympanic injection of gentamicin. Subjective improvement of quality of life and audiologic and vestibular assessment. We obtained a subjective improvement in the quality of life for all the 4 patients. In fact, disabling vertigo disappeared in all cases; 3 patients recovered their posttreatment unsteadiness after a period of vestibular rehabilitation, whereas one of them complained of persistent unsteadiness. The hearing remained unchanged in 3 patients, whereas in one, the pretreatment severe sensorineural hearing loss progressed to anacusis. This treatment represents an additional option in patients with small not-growing tumor affected by vestibular symptoms to be combined with a wait-and-scan policy.