title: Intratympanal gentamicin in Meniere's disease: Effects on individual semicircular canals.
abstract: OBJECTIVE
  In this retrospective study the aim of the authors was to examine the effect of gentamicin on the individual semicircular canals after low dose, single injection intratympanal gentamicin therapy in Meniere's disease.
  
  
  METHODS
  Data of 32 patients treated between 2011 and 2015 were collected. The high frequency, high acceleration vestibuloocular reflex (VOR) gain was measured in the individual semicircular canals using video head impulse test immediately before the first intratympanal gentamicin instillation and approximately two months later.
  
  
  RESULTS
  In all cases 'AAO-HNS Class A' vertigo control could be attained at least for several months. In 13 cases only one instillation was necessary. In the other 19 cases the attacks returned after a few months. In 11 cases the injection had to be repeated a second time, in 4 cases 3 injections, in 2 cases 4, in 1 case 5 injections and in another 6 injections were necessary. The initial VOR gain was normal in all cases and two months after one injection it decreased in average by 40% in a highly significant manner. However, there were cases in which, although the patients became free of attacks, the gain values remained normal.
  
  
  CONCLUSIONS
  It was possible to demonstrate a significant correlation between the gain decrease of the individual canals. There was no prognostic correlation between the initial gain decrease after the first injection and the necessity of further injections. Gain values also decreased slightly but significantly in the lateral and posteriors canals on the contralateral, untreated side, possibly because of the missing disfacilitation from the treated side.
authors.affiliation: Department of Otolaryngology, Karl Landsteiner University Hospital Krems, Krems an der Donau, Austria. Electronic address: bukibela@hotmail.com.
authors.forename: Béla
authors.initials: B
authors.lastname: Büki
authors.affiliation: Department of Otolaryngology, Karl Landsteiner University Hospital Krems, Krems an der Donau, Austria.
authors.forename: Heinz
authors.initials: H
authors.lastname: Jünger
mesh_terms: D000328:Adult; D005260:Female; D005839:Gentamicins / Q000008:administration & dosage / Q000494:pharmacology*; D064087:Head Impulse Test; D006801:Humans; D000069555:Injection, Intratympanic; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy* / Q000503:physiopathology; D011500:Protein Synthesis Inhibitors / Q000008:administration & dosage / Q000494:pharmacology*; D012027:Reflex, Vestibulo-Ocular / Q000187:drug effects*; D012189:Retrospective Studies; D012665:Semicircular Canals / Q000187:drug effects*; D014717:Vertigo / Q000188:drug therapy
chemical_list: D005839:Gentamicins; D011500:Protein Synthesis Inhibitors
keywords: Head impulse test; Intratympanal gentamicin; Meniere’s disease