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Gentamicin treatment in peripheral vestibular disorders other than Ménière's disease
K Brantberg1, J Bergenius, A Tribukait
1Department of Audiology, Karolinska Hospital, Stockholm, Sweden.
Abstract:
Intratympanic instillation of gentamicin may not exclusively be a treatment for Ménière's disease. We present case reports of successful vertigo control in peripheral vestibular disorders other than Ménère's disease. Cases 1 and 2 illustrate treatment of vertigo attacks caused by vestibular dysfunction in deaf ears. Case 3 illustrates treatment of brief sensations of linear acceleration in a patient who had suffered idiopathic sudden hearing loss a few years earlier. Case 4 illustrates treatment of disabling benign paroxysmal positioning vertigo. Case 5 illustrates treatment of severe and frequent attacks of vertigo in an elderly patient with a medium-sized acoustic neuroma who did not want surgical extirpation of the tumor.
Insights
Intratympanic gentamicin injections effectively manage vertigo in various peripheral vestibular disorders beyond Ménière's disease. This treatment offers relief for conditions like vestibular dysfunction, sudden hearing loss sequelae, and benign paroxysmal positioning vertigo.
Area of Science:
- Otolaryngology
- Neurology
- Vestibular System Disorders
Background:
- Intratympanic gentamicin is a recognized treatment for Ménière's disease.
- Its efficacy in other peripheral vestibular disorders is less established.
Observation:
- This study presents five case reports detailing the use of intratympanic gentamicin.
- The cases involve diverse peripheral vestibular conditions, including vestibular dysfunction in deaf ears, post-idiopathic sudden hearing loss vertigo, benign paroxysmal positioning vertigo, and vertigo associated with acoustic neuroma.
Findings:
- Successful vertigo control was achieved in all five cases.
- Gentamicin provided relief for vertigo attacks and sensations of linear acceleration in non-Ménière's conditions.
- The treatment was effective even in complex cases, such as in elderly patients or those with acoustic neuroma.
Implications:
- Intratympanic gentamicin may be a viable therapeutic option for a broader range of peripheral vestibular disorders.
- This expands the potential applications of gentamicin beyond its traditional use in Ménière's disease.
- Further research could validate these findings and establish treatment protocols for these conditions.