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

• Tipo: Artigo em Revista Científica Internacional
• Data: 2015

Autores

Marques, P (Autor) FMUP; Manrique Huarte, R (Autor) Outra; Perez Fernandez, N (Autor) Outra

Revista

Título: Laryngoscope

Vol. 125 Nº 1

Páginas: 1915-1920

ISSN: 0023-852X

Editora: Wiley-Blackwell

Indexação

ISI Web of Knowledge - 26 Citações

Scopus - 35 Citações

Outras Informações

ID Authenticus: 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

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 6