Reversible tobramycin-induced bilateral high-frequency vestibular toxicity

Area of Science:

• Ototoxicology
• Neurovestibular Science

Background:

• Aminoglycoside antibiotics, like tobramycin, are known for potential ototoxicity.
• Vestibular toxicity can manifest in various forms, affecting balance and vision.

Observation:

• A patient presented with symptoms suggestive of bilateral vestibular toxicity after tobramycin treatment.
• Standard low-frequency vestibular tests (ENG-caloric) showed normal results.

Findings:

• High-frequency rotation chair testing revealed a specific high-frequency vestibular deficit.
• The patient demonstrated subsequent clinical and objective evidence of functional vestibular recovery.

Implications:

• High-frequency rotation chair testing is essential for diagnosing tobramycin-induced high-frequency vestibular toxicity when low-frequency tests are normal.
• This highlights the importance of targeted diagnostic tools for specific patterns of ototoxicity.
• Understanding functional recovery in vestibular toxicity can inform patient management and rehabilitation strategies.