The use of intratympanic gentamicin in patients with vestibular schwannoma and disabling vertigo.
OBJECTIVE
To document the effect of intratympanic gentamicin as treatment of disabling vertigo secondary to a vestibular schwannoma in elderly patients.


METHODS
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.


METHODS
Intratympanic injection of gentamicin.


METHODS
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.


CONCLUSIONS
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.
Gruppo Otologico, Piacenza, Italy. al.giannuzzi@gruppootologico.it
Anna Lisa
AL
Giannuzzi
Paul
P
Merkus
Maurizio
M
Falcioni
D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000008:administration & dosage* / Q000627:therapeutic use*; D001301:Audiometry, Pure-Tone; D002150:Caloric Tests; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage* / Q000627:therapeutic use*; D006801:Humans; D008845:Microinjections; D009464:Neuroma, Acoustic / Q000150:complications / Q000188:drug therapy* / Q000473:pathology; D009760:Nystagmus, Physiologic; D013506:Otologic Surgical Procedures; D012405:Round Window, Ear; D013063:Speech Discrimination Tests; D016896:Treatment Outcome; D014432:Tympanic Membrane; D014717:Vertigo / Q000188:drug therapy* / Q000209:etiology
D000900:Anti-Bacterial Agents; D005839:Gentamicins