The Use of Intratympanic Gentamicin in Patients With Vestibular Schwannoma and Disabling Vertigo
The Use of Intratympanic Gentamicin in Patients With Vestibular Schwannoma and Disabling Vertigo
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DOI：
10.1097/mao.0b013e3182804c41
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发表时间：
2013-08-01
影响因子：
2.1
通讯作者：
Falcioni, Maurizio
中科院分区：
文献类型：
--
作者：
Giannuzzi, Anna Lisa;Merkus, Paul;Falcioni, Maurizio
目的：探讨庆大霉素鼓室内注射治疗老年前庭神经鞘瘤继发的致残性眩晕的疗效。患者：4例前庭神经鞘瘤患者，外径小于1 cm，出现致残性眩晕，采取等待-扫描策略。干预：鼓室内注射庆大霉素。主要观察指标：主观生活质量改善及听力学和前庭评估。结果：4例患者的生活质量均有主观改善。事实上，所有病例的致残性眩晕都消失了；3例患者在经过一段时间的前庭康复后恢复了治疗后的不稳定，其中1例主诉持续不稳定。3名患者听力保持不变，而1名患者在治疗前严重感音神经性听力损失进展为听力障碍。结论：对于受前庭症状影响的小而不长的肿瘤患者，这种治疗方法是一种结合等待和扫描策略的额外选择。
Objective: To document the effect of intratympanic gentamicin as treatment of disabling vertigo secondary to a vestibular schwannoma in elderly patients.Patients: 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.Intervention: Intratympanic injection of gentamicin.Main Outcome Measures: 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.Conclusion: 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.