Otology & neurotology : official publication of the American Otological Society, American Neurotology Society [and] European Academy of Otology and Neurotology · 2013
The use of intratympanic gentamicin in patients with vestibular schwannoma and disabling vertigo.
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Giannuzzi Anna Lisa, Merkus Paul, Falcioni Maurizio
Аннотация
OBJECTIVE: To document the effect of intratympanic gentamicin as treatment of disabling vertigo secondary to a vestibular schwannoma in elderly patients.
PATIENTS: Four elderly patients with a vestibular schwannoma, with an extrameatal diameter of less than 1 cm, experiencing disabling vertigo and followed a wait-and-scan policy.
INTERVENTION: Intratympanic injection of gentamicin.
MAIN OUTCOME MEASURES: Subjective improvement of quality of life and audiologic and vestibular assessment.
RESULTS: We obtained a subjective improvement in the quality of life for all the 4 patients. In fact, disabling vertigo disappeared in all cases; 3 patients recovered their posttreatment unsteadiness after a period of vestibular rehabilitation, whereas one of them complained of persistent unsteadiness. The hearing remained unchanged in 3 patients, whereas in one, the pretreatment severe sensorineural hearing loss progressed to anacusis.
CONCLUSION: This treatment represents an additional option in patients with small not-growing tumor affected by vestibular symptoms to be combined with a wait-and-scan policy.
PATIENTS: Four elderly patients with a vestibular schwannoma, with an extrameatal diameter of less than 1 cm, experiencing disabling vertigo and followed a wait-and-scan policy.
INTERVENTION: Intratympanic injection of gentamicin.
MAIN OUTCOME MEASURES: Subjective improvement of quality of life and audiologic and vestibular assessment.
RESULTS: We obtained a subjective improvement in the quality of life for all the 4 patients. In fact, disabling vertigo disappeared in all cases; 3 patients recovered their posttreatment unsteadiness after a period of vestibular rehabilitation, whereas one of them complained of persistent unsteadiness. The hearing remained unchanged in 3 patients, whereas in one, the pretreatment severe sensorineural hearing loss progressed to anacusis.
CONCLUSION: This treatment represents an additional option in patients with small not-growing tumor affected by vestibular symptoms to be combined with a wait-and-scan policy.