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Topical gentamicin-induced acute vestibulopathy: A case report
Teik Beng Lau1, Jeyasakthy Saniasiaya2, Revadi Govindaraju3
1MBBS, Department of Otorhinolaryngology, Faculty of Medicine, Universiti Malaya, Jalan Universiti, Kuala Lumpur, Malaysia.
Topical aminoglycosides are rarely ototoxic, unlike systemic use. This case highlights potential vestibulotoxicity from topical gentamicin ear drops, emphasizing the need for awareness.
Area of Science:
- Otolaryngology
- Nephrology
- Pharmacology
Background:
- Aminoglycosides administered systemically are known ototoxic agents, causing cochlear and vestibular damage.
- Ototopical aminoglycosides are generally considered safe for ear infections with an intact tympanic membrane.
- Factors contributing to lower topical ototoxicity include protective barriers and lower drug concentrations.
Observation:
- A patient developed acute vestibulopathy after a two-week course of topical gentamicin otic drops.
- This contrasts with the generally accepted low risk of ototoxicity from topical aminoglycosides.
Findings:
- Topical gentamicin, despite its formulation for ear use, can cause significant vestibular dysfunction.
- The case suggests that topical aminoglycoside ototoxicity may be under-recognized.
Implications:
- Clinicians should maintain awareness of potential vestibulotoxicity from topical gentamicin therapy.
- Prompt recognition and management of vestibulopathic symptoms are crucial due to their debilitating nature.
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