Benefits of pre-labyrinthectomy intratympanic gentamicin: contralateral vestibular responses

Abstract

ObjectiveTo determine the impact of pre-operative intratympanic gentamicin injection on the recovery of patients undergoing translabyrinthine resection of vestibular schwannomas.MethodsThis prospective, case–control pilot study included eight patients undergoing surgical labyrinthectomy, divided into two groups: four patients who received pre-operative intratympanic gentamicin and four patients who did not. The post-operative six-canal video head impulse test responses and length of in-patient stay were assessed.ResultsThe average length of stay was shorter for patients who received intratympanic gentamicin (6.75 days; range, 6–7 days) than for those who did not (9.5 days; range, 8–11 days) (p = 0.0073). Additionally, the gentamicin group had normal post-operative video head impulse test responses in the contralateral ear, while the non-gentamicin group did not.ConclusionPre-operative intratympanic gentamicin improves the recovery following vestibular schwannoma resection, eliminating, as per the video head impulse test, the impact of labyrinthectomy on the contralateral labyrinth.

Pre-habilitation with intratympanic gentamicin in vestibular schwannomas: a systematic review

“…5,9,10,18 The work by Amiraraghi et al . 16 showed, using Video Head Impulse Tests, the milder effect of surgery on the contralateral side in patients from the gentamicin group, providing a reasonable explanation of the positive effect of pre-habilitation.…”

“…The findings and characteristics of the included studies have been summarised (Tables 1–3) to allow for overview and comparison. 9–16…”

Intratympanale Medikamentenapplikation – Indikationen und Ablauf

“…[31]. In weiteren kleineren Studien zeigten sich ebenfalls teilweise gegenläufige Untersuchungsergebnisse bezüglich des postoperativen Schwindels und der schnelleren postoperativen Rehabilitation [32].…”

Translabyrinthine resection of NF2 associated vestibular schwannoma with cochlear implant insertion

“…She experienced no vestibular symptoms postoperatively, which we attribute at least partially to our administration of intratympanic gentamicin preoperatively, which has been instrumental in reducing our length of stay following VS surgery. 9 The patient will continue to be reviewed under the auspices of the NF2 service in Manchester, with a plan for continued radiological surveillance of the contralateral VS.…”

“…She experienced no vestibular symptoms postoperatively, which we attribute at least partially to our administration of intratympanic gentamicin preoperatively, which has been instrumental in reducing our length of stay following VS surgery. 9 …”