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Gentamicin perfusion vestibular response and hearing loss
Joshua P Light1, Herbert Silverstein, Lance E Jackson
1Ear Research Foundation, Florida Ear and Sinus Center, Sarasota, Florida, USA.
Summary
Gentamicin perfusion for Ménière's Disease offers similar vertigo control whether hearing is functional or not. However, achieving less than 75% vestibular response may reduce hearing loss risk.
Area of Science:
- Otolaryngology
- Neurology
Background:
- Ménière's Disease is a disorder of the inner ear.
- Vestibular ablation is a treatment option for Ménière's Disease.
Purpose of the Study:
- To compare hearing outcomes after gentamicin perfusion for Ménière's Disease based on vestibular ablation levels.
- To assess the relationship between vestibular ablation, vertigo control, and hearing loss.
Main Methods:
- Retrospective review of 45 patients with Ménière's Disease treated with gentamicin perfusion via the MicroWick device.
- Audiologic, vestibular, and symptom data were analyzed.
- Patients were grouped by reduced vestibular response (RVR) levels: Group 1 (<75% RVR) and Group 2 (>75% RVR).
Main Results:
- Patients with functional hearing had similar vertigo control rates compared to those without.
- A statistically significant difference in persistent vertigo was observed between groups (p = 0.007), with more in Group 1.
- Hearing loss was significantly greater in Group 2 (15 dB average drop) compared to Group 1 (3 dB average drop) (p = 0.01).
Conclusions:
- The degree of vestibular ablation correlates with vertigo control and hearing loss risk.
- Maintaining some residual vestibular function (75-100% RVR) may offer adequate vertigo control with a lower risk of hearing loss.
- Further research is needed to establish optimal RVR targets for Ménière's Disease treatment.
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