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Intratympanic Gentamicin Versus Labyrinthectomy: Inner Ear Sensitivity to Gentamicin and Impact on the Contralateral
Georgios Kontorinis1, Hiteshkumar Tailor1, Margaret Gaggini1
1Department of Otolaryngology-Head and Neck Surgery, Queen Elizabeth University Hospital, Glasgow, UK.
Clinical and Experimental Otorhinolaryngology
|May 22, 2019
Summary
Labyrinthectomy impacts the contralateral labyrinth, while intratympanic gentamicin ablates ipsilateral vestibular function without affecting the other ear. Gentamicin affects lateral, then posterior, and lastly superior semicircular canals.
Area of Science:
- Vestibular science
- Otolaryngology
- Neuroscience
Background:
- Unilateral vestibular pathology affects balance and spatial orientation.
- Treatment options include labyrinthectomy and intratympanic (IT) gentamicin injections.
- The impact of these treatments on the contralateral labyrinth is not fully understood.
Purpose of the Study:
- To compare the effects of labyrinthectomy and IT gentamicin on the contralateral labyrinth.
- To determine the order in which IT gentamicin affects individual semicircular canals.
Main Methods:
- Pilot observational study with 13 patients (unilateral vestibular pathology).
- Two groups: IT gentamicin (n=7) and labyrinthectomy (n=6).
- Six-canal video-head-impulse test (vHIT) performed at intervals; gentamicin group tested after each injection.
Main Results:
- Labyrinthectomy led to abnormal contralateral responses in at least one canal.
- IT gentamicin did not cause abnormal contralateral responses.
- IT gentamicin affected semicircular canals in the order: lateral, posterior, superior.
Conclusions:
- Labyrinthectomy affects contralateral vestibular function, unlike IT gentamicin.
- IT gentamicin ablates ipsilateral function gradually, preserving contralateral function.
- Established the sequence of semicircular canal response to IT gentamicin.
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