Angular vestibulo-ocular reflex gains correlate with vertigo control after intratympanic gentamicin treatment for Meniere's disease.
OBJECTIVE
The objective of our study was to determine whether angular vestibulo-ocular reflex (aVOR) gains correlated with vertigo control after intratympanic gentamicin treatment for Meniere's disease.


METHODS
We conducted a prospective study of 18 subjects with unilateral Meniere's disease treated with intratympanic gentamicin injection and followed all subjects for 1 year. We measured the gain of the aVOR elicited by rapid rotary head thrusts in each of the canal planes for each subject before and after treatment with intratympanic gentamicin by using magnetic search coils to record eye movements.


RESULTS
During the follow-up period, 11 subjects ("single-treatment group"; 61%) had control of their vertigo with a single gentamicin injection. The remaining 7 subjects ("multiple-treatment group"; 39%) experienced recurrent vertigo that required a second injection of gentamicin at a mean of 6 months after the first treatment. The 11 subjects in the single-treatment group had significantly greater reduction of labyrinthine function after the first treatment, as measured by change in ipsilateral horizontal canal gain, than did the 7 subjects with vertigo recurrence. Changes in caloric asymmetry did not correlate with vertigo control.


CONCLUSIONS
Our results suggest that successful treatment of Meniere's disease is closely related to attenuation of semicircular canal function as measured by horizontal canal aVOR gains.
Lin
Frank R
FR
Department of Otolaryngology-Head and Neck Surgery, The Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Migliaccio
Americo A
AA
Haslwanter
Thomas
T
Minor
Lloyd B
LB
Carey
John P
JP
D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage*; D002150:Caloric Tests; D005839:Gentamicins / Q000008:administration & dosage*; D006801:Humans; D015552:Injections, Intralesional; D008575:Meniere Disease / Q000188:drug therapy* / Q000503:physiopathology*; D008875:Middle Aged; D012027:Reflex, Vestibulo-Ocular / Q000502:physiology*; D012665:Semicircular Canals / Q000503:physiopathology; D014432:Tympanic Membrane; D014717:Vertigo / Q000517:prevention & control*
D000900:Anti-Bacterial Agents; D005839:Gentamicins