Permanent Gentamicin Vestibulotoxicity

Fo, Black; Pesznecker, Susan; Stallings,

doi:10.1097/00129492-200407000-00025

Cited by 147 publications

(144 citation statements)

References 26 publications

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“…1 Frequently permanent, toxicity can result in failure to return to work and diminished quality of life. 2 Gentamicin, tobramycin and streptomycin are preferentially vestibulotoxic, whereas amikacin and kanamycin are primarily cochleotoxic. 1,2 Ototoxicity may develop with the use of ear drops, particularly in the presence of tympanic membrane perforation or tympanostomy tubes.…”

Section: Aminoglycoside-induced Ototoxicity Can Profoundly Affect Quamentioning

confidence: 99%

“…2 Gentamicin, tobramycin and streptomycin are preferentially vestibulotoxic, whereas amikacin and kanamycin are primarily cochleotoxic. 1,2 Ototoxicity may develop with the use of ear drops, particularly in the presence of tympanic membrane perforation or tympanostomy tubes. 3 In this situation, alternative antimicrobial drops should be selected.…”

Section: Aminoglycoside-induced Ototoxicity Can Profoundly Affect Quamentioning

confidence: 99%

“…Vestibulotoxicity typically manifests with ataxia, dysequilib rium and oscillopsia (visual blurring with head movement), which should be elicited on history taking. 1,2,6 Ver tigo is usually absent, because ami noglycosideinduced toxicity causes symmetric bilateral vestibular loss. 1 Appropriate questioning is needed to ensure early detection and prompt discontinuation of therapy.…”

Section: 5mentioning

confidence: 99%

“…6 Although prospective trials show ing efficacy are lacking, additional monitoring should be considered for patients receiving more than seven days of treatment. 1,2,5,6 Cochleotoxicity may be detected with high frequency audi ometry. For patients in hospital, dy namic visual acuity testing may be used to detect vestibulotoxicity at the bedside (Appendix 1, available at www .cmaj.ca /lookup/suppl/doi:10.1503/cmaj .140339 //DC1).…”

Section: Normal Laboratory Monitoring May Provide False Reassurancementioning

confidence: 99%

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Aminoglycoside-induced ototoxicity

Leis

Gold

2014

CMAJ

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Section: Aminoglycoside-induced Ototoxicity Can Profoundly Affect Quamentioning

confidence: 99%

Section: Aminoglycoside-induced Ototoxicity Can Profoundly Affect Quamentioning

confidence: 99%

Section: 5mentioning

confidence: 99%

Section: Normal Laboratory Monitoring May Provide False Reassurancementioning

confidence: 99%

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Aminoglycoside-induced ototoxicity

Leis

Gold

2014

CMAJ

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“…However, those with bilateral vestibular deficiency (BVD) due to ototoxic drug exposure, Ménière's disease, meningitis, genetic defects, or other insults to the inner ear often suffer from degraded visual acuity during head movements, in addition to postural instability and chronic disequilibrium (Minor 1998;Rinne et al 1998;Black et al 2001Black et al , 2004Mamoto et al 2002). For these individuals, an implantable neuroelectronic prosthesis that measures three-dimensional (3D) head rotation and stimulates the vestibular nerve accordingly could significantly improve quality of life.…”

Section: Introductionmentioning

confidence: 99%

Multichannel Vestibular Prosthesis Employing Modulation of Pulse Rate and Current with Alignment Precompensation Elicits Improved VOR Performance in Monkeys

Davidovics

Rahman

Dai

et al. 2013

JARO

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An implantable prosthesis that stimulates vestibular nerve branches to restore the sensation of head rotation and the three-dimensional (3D) vestibular ocular reflex (VOR) could benefit individuals disabled by bilateral loss of vestibular sensation. Our group has developed a vestibular prosthesis that partly restores normal function in animals by delivering biphasic current pulses via electrodes implanted in semicircular canals. Despite otherwise promising results, this approach has been limited by insufficient velocity of VOR response to head movements that should inhibit the implanted labyrinth and by misalignment between direction of head motion and prosthetically elicited VOR. We report that significantly larger VOR eye velocities in the inhibitory direction can be elicited by adapting a monkey to elevated baseline stimulation rate and current prior to stimulus modulation and then concurrently modulating ("co-modulating") both rate and current below baseline levels to encode inhibitory angular head velocity. Comodulation of pulse rate and current amplitude above baseline can also elicit larger VOR eye responses in the excitatory direction than do either pulse rate modulation or current modulation alone. Combining these stimulation strategies with a precompensatory 3D coordinate transformation improves alignment and magnitude of evoked VOR eye responses. By demonstrating that a combination of co-modulation and precompensatory transformation strategies achieves a robust VOR response in all directions with significantly improved alignment in an animal model that closely resembles humans with vestibular loss, these findings provide a solid preclinical foundation for application of vestibular stimulation in humans.

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Hearing Loss in Patients With Vestibulotoxic Reactions to Gentamicin Therapy

Dobie

Black

Pezsnecker

et al. 2006

Arch Otolaryngol Head Neck Surg

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To determine whether patients with vestibulotoxic reactions to gentamicin have hearing thresholds worse than predicted by distributions of better-ear hearing thresholds in people of the same age and sex in the general population, and, if so, to measure the severity and audiometric pattern of that hearing loss. Design: Retrospective case series from previously published prospective and retrospective studies of vestibular function in patients receiving gentamicin. Setting: Tertiary neurotological practice. Patients: Convenience sample of 33 consecutive patients seen for objective evidence of vestibulotoxic reactions after systemic gentamicin therapy. Twenty-five of 33 patients underwent valid and complete audiometry. Main Outcome Measures: Age-and sex-corrected better-ear pure tone thresholds, 0.5 to 6.0 kHz. The betterear audiogram was defined in 2 ways: primarily, the audiogram of the ear with the better average threshold at 0.5, 1.0, and 2.0 kHz; secondarily, the composite audiogram taking the better threshold for each frequency. Results: Patients exhibiting vestibulotoxic reactions to gentamicin therapy had hearing thresholds that were similar to those seen in the general population at 0.5, 3.0, and 6.0 kHz. Median thresholds were 6 to 7 dB worse than expected at 1.0 and 2.0 kHz (95% confidence intervals, 2-13 dB and 3-12 dB, respectively). The largest median difference was 15 dB at 4.0 kHz (95% confidence interval, 3-23 dB), but this difference was not significant for the more conservative composite definition of the better ear. Conclusions: Patients with vestibulotoxic reactions to gentamicin therapy have little additional hearing loss compared with the general population. Physicians should monitor both auditory and vestibular function when aminoglycosides, especially gentamicin, must be used.

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Permanent Gentamicin Vestibulotoxicity

Cited by 147 publications

References 26 publications

Aminoglycoside-induced ototoxicity

Aminoglycoside-induced ototoxicity

Multichannel Vestibular Prosthesis Employing Modulation of Pulse Rate and Current with Alignment Precompensation Elicits Improved VOR Performance in Monkeys

Hearing Loss in Patients With Vestibulotoxic Reactions to Gentamicin Therapy

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