Single intratympanic gentamicin injection in Meniere's disease: VOR change and prognostic usefulness

• Type: Article in International Scientific Journal
• Date: 2015

Authors

Marques, P (Author) FMUP; Manrique Huarte, R (Author) Other; Perez Fernandez, N (Author) Other

Journal

Title: Laryngoscope

Vol. 125 No. 1

Pages: 1915-1920

ISSN: 0023-852X

Publisher: Wiley-Blackwell

Indexing

ISI Web of Knowledge - 26 Citations

Scopus - 35 Citations

Other information

Authenticus ID: P-00G-EK6

DOI: 10.1002/lary.25156

Abstract (EN): ObjectiveAssess angular vestibular-ocular reflex (VOR) changes after treatment with intratympanic gentamicin (ITG) for Meniere's disease (MD) and impact on short-term follow-up. DesignProspective study. MethodsPatients submitted to ITG for unilateral MD. The gain VOR and the presence of compensatory saccades elicited by rapid head impulses were measured using the video head impulse test (vHIT). ResultsThe study included 31 subjects (mean age: 59 years). Functional Level Scale (FLS) distributions were 35,5% (FLS3); 32,2% (FLS4); and 32,2% (FLS5). Mean follow-up was 217 months. Multiple injections were needed in nine patients. VOR gain in the treated ear was significantly reduced in all subjects and for all the semicircular canals (paired samples t test; P<0,05). Gain averages after treatment were 0,61 (superior); 0,69 (horizontal); and 0,47 (posterior). A horizontal canal VOR gain superior to 0,80 after treatment was associated with the need for a second gentamicin injection (Chi-square; P=0,003). Gain asymmetry between the symptomatic and asymptomatic ear (GASM) was increased after treatment. The rate of vestibular function reduction was 47,9%; 26,0%; and 35,8% for the superior, horizontal, and posterior canals, respectively. According to the receiving operator characteristic curve, the amount of change in GASM must be greater than 7 in order to predict the avoidance of a second procedure (area under the curve [AUC] horizontal canal=0,861) and the amount of vestibular function reduction in the pathologic ear in patients with a controlled disease must be greater than 17,8% (AUC horizontal canal=0,843). ConclusionsWhen evaluated with the vHIT, intratympanic gentamicin changes in VOR seem to foresee short-term control of vertigo attacks. Level of Evidence4. Laryngoscope, 125:1915-1920, 2015

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 6