Use of Skull Vibration-Induced Nystagmus in the Follow-up of Patients With Ménière Disease Treated With Intratympanic Gentamicin
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Objectives. Ménière disease (MD) is an idiopathic disorder that affects hearing and inner ear balance. Intratympanic genta-micin (ITG) is recognized as an effective treatment for uncontrolled MD characterized by persistent vertigo attacksdespite therapy. The video head impulse test (vHIT) and skull vibration-induced nystagmus (SVIN) are validated meth-ods for evaluating vestibular function. A progressive linear relationship has been identified between the slow-phasevelocity (SPV) of SVIN determined using a 100-Hz skull vibrator and the gain difference (healthy ear/affected ear)measured by vHIT. The aim of this study was to ascertain whether the SPV of SVIN was associated with the recoveryof vestibular function following ITG treatment. Consequently, we sought to determine whether SVIN could predictthe onset of new vertigo attacks in patients with MD who were treated with ITG. Methods. A prospective longitudinal case-control study was conducted. Several variables were recorded post-ITG and through-out the follow-up period, followed by statistical analyses. Two groups were compared: patients who experienced ver-tigo attacks 6 months after ITG and those who did not. Results. The sample comprised 88 patients diagnosed with MD who underwent ITG treatment. Of the 18 patients who ex-perienced recurring vertigo attacks, 15 demonstrated gain recovery in the affected ear. However, all 18 patients ex-hibited a decrease in the SPV of SVIN. Conclusion. The SPV of SVIN may be more sensitive than vHIT in identifying the recovery of vestibular function followingITG administration. To our knowledge, this is the first study to illustrate the link between a reduction in SPV and thelikelihood of vertigo episodes in patients with MD who have been treated with ITG.
Abstract
Objectives. Ménière disease (MD) is an idiopathic disorder that affects hearing and inner ear balance. Intratympanic genta-micin (ITG) is recognized as an effective treatment for uncontrolled MD characterized by persistent vertigo attacksdespite therapy. The video head impulse test (vHIT) and skull vibration-induced nystagmus (SVIN) are validated meth-ods for evaluating vestibular function. A progressive linear relationship has been identified between the slow-phasevelocity (SPV) of SVIN determined using a 100-Hz skull vibrator and the gain difference (healthy ear/affected ear)measured by vHIT. The aim of this study was to ascertain whether the SPV of SVIN was associated with the recoveryof vestibular function following ITG treatment. Consequently, we sought to determine whether SVIN could predictthe onset of new vertigo attacks in patients with MD who were treated with ITG. Methods. A prospective longitudinal case-control study was conducted. Several variables were recorded post-ITG and through-out the follow-up period, followed by statistical analyses. Two groups were compared: patients who experienced ver-tigo attacks 6 months after ITG and those who did not. Results. The sample comprised 88 patients diagnosed with MD who underwent ITG treatment. Of the 18 patients who ex-perienced recurring vertigo attacks, 15 demonstrated gain recovery in the affected ear. However, all 18 patients ex-hibited a decrease in the SPV of SVIN. Conclusion. The SPV of SVIN may be more sensitive than vHIT in identifying the recovery of vestibular function followingITG administration. To our knowledge, this is the first study to illustrate the link between a reduction in SPV and thelikelihood of vertigo episodes in patients with MD who have been treated with ITG.
참고문헌 (40)
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