Unilateral vestibular loss due to systemically administered gentamicin

Area of Science:

• Otolaryngology
• Neurology
• Pharmacology

Background:

• Systemic gentamicin is known to cause ototoxicity, typically affecting the bilateral vestibular system.
• Unilateral vestibular loss is often associated with vertigo, which was absent in the studied patient group.

Purpose of the Study:

• To highlight the underrecognized potential of systemic gentamicin to induce severe unilateral vestibular loss.
• To differentiate this presentation from the more common bilateral vestibular damage.

Main Methods:

• Retrospective review of patients diagnosed with compensated, selective unilateral vestibular loss presenting with imbalance and oscillopsia.
• Analysis of patient histories and hospital records to identify prior systemic gentamicin administration.

Main Results:

• Eighteen patients with unilateral vestibular loss and no history of vertigo were identified.
• Gentamicin administration was confirmed via hospital chart review in all cases, though only 4 patients were aware of receiving it.

Conclusions:

• Patients presenting with unilateral vestibular loss without vertigo may have experienced subclinical gentamicin ototoxicity.
• Thorough patient history and scrutiny of hospital records for gentamicin exposure are crucial for diagnosis.