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Vestibular system in infants after systemic therapy with amikacin

Olaf Zagólski1

  • 1Diagnostic and Therapeutic Medical Centre Medicina, Kraków, Poland. olafzag@poczta.onet.pl

Journal of Otolaryngology - Head & Neck Surgery = Le Journal D'Oto-Rhino-Laryngologie Et De Chirurgie Cervico-Faciale
|January 9, 2009
PubMed

Insights

Aminoglycoside antibiotics can damage infant vestibular function. Caloric tests and vestibular evoked myogenic potentials (VEMPs) revealed more frequent vestibular than cochlear damage, highlighting the need for routine vestibular screening in infants post-treatment.

Area of Science:

  • Pediatric Otolaryngology
  • Neuroscience
  • Pharmacology

Background:

  • Aminoglycosides are crucial for treating infant infections but carry ototoxic risks.
  • Routine infant inner ear examinations often omit vestibular function tests.
  • Vestibular damage can have significant long-term impacts on development.

Purpose of the Study:

  • To evaluate vestibular function in infants before and after aminoglycoside therapy.
  • To compare the sensitivity of caloric tests and VEMPs in detecting aminoglycoside-induced ototoxicity.
  • To determine if vestibular or cochlear function is more affected by amikacin treatment.

Main Methods:

  • A randomized clinical study involving 68 infants (2.5-3.5 months old) at a tertiary referral center.
  • Vestibular evoked myogenic potentials (VEMPs) and caloric stimulation were performed on 28 infants treated with amikacin and 40 healthy controls.
  • Tests were conducted upon hospital admission and discharge to assess changes in vestibular function.

Main Results:

  • No caloric stimulation response in 6 infants and no VEMPs in 4 infants upon discharge.
  • Hearing thresholds remained normal in all infants throughout the study.
  • Caloric testing proved more sensitive than VEMPs in detecting amikacin's ototoxic effects on vestibular receptors.

Conclusions:

  • Amikacin treatment can damage both semicircular canal and otolith organ receptors in infants.
  • The semicircular canal receptors appear to be more frequently impaired.
  • Routine vestibular testing is recommended for infants following aminoglycoside therapy to monitor for ototoxicity.
Abstract

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