Dynamic Change of VOR and Otolith Function in Intratympanic Gentamicin Treatment for Ménière’s Disease: Case Report and Review of the LiteratureReportar como inadecuado




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Case Reports in OtolaryngologyVolume 2013 2013, Article ID 168391, 5 pages

Case Report

Department of Otorhinolaryngology, Head and Neck Surgery, University Medicine Mannheim, Ruprecht-Karls-University Heidelberg, 68135 Mannheim, Germany

Department of Otorhinolaryngology, Head and Neck Surgery, Helios Clinic Berlin-Buch, 13125 Berlin, Germany

Received 14 December 2012; Accepted 28 January 2013

Academic Editors: M. Berlucchi, J. I. De Diego, M. T. Kalcioglu, and K. Morshed

Copyright © 2013 L. E. Walther et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Intratympanic gentamicin treatment IGT is an evidence-based therapeutic option for recurrent vertigo attacks in Ménière’s disease MD. Today, in MD it is possible to monitor changes of vestibular receptor function, induced by IGT, with objective test methods such as the video head impulse test vHIT and cervical and ocular vestibular evoked myogenic potentials cVEMP, oVEMP in a dynamic, time-and frequency-dependent manner. We report on a 65-year-old female patient with recurrent vertigo attacks in a right-sided MD, where receptor function was followed up before and up to 4 weeks after IGT time dynamic. Quantitative changes of vestibular function frequency dynamic were detected with bithermal calorics and vHIT, with air-conducted sound ACS cVEMP and bone-conducted vibration BCV oVEMP at 500 Hz. The horizontal vestibuloocular reflex hVOR gain in vHIT decreased successively until the 4th week with the appearance of catch-up covert and catch-up overt refixation saccades, and side asymmetry increased in caloric testing. Saccular function was extinguished within 4 weeks, whereas utricular function was diminished after 4 weeks. Monitoring vestibular receptor function with objective test methods provides a quantitative insight into the dynamic activity of vestibular function and is therefore applicable in order to adjust IGT regimen at different therapeutic stages.





Autor: L. E. Walther, R. Huelse, K. Blättner, M. B. Bloching, and A. Blödow

Fuente: https://www.hindawi.com/



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