{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T01:43:15Z","timestamp":1785807795365,"version":"3.56.0"},"reference-count":43,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2022,3,18]],"date-time":"2022-03-18T00:00:00Z","timestamp":1647561600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>The number of intratympanic gentamicin (ITG) injections needed to achieve vertigo control in patients with intractable M\u00e9ni\u00e8re's disease (MD) may vary from a single dose to several instillations. Changes in different vestibular test results have been used to define an endpoint of treatment, including the decrease of the vestibulo-ocular reflex (VOR) gain elicited by the head-impulse test.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To assess the accuracy of the VOR gain reduction after horizontal canal stimulation, as measured with the video head-impulse test (vHIT) 1 month after the first intratympanic injection, in predicting the need for one or more instillations to control vertigo spells in the long term.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The VOR gain reduction was calculated in 47 patients submitted to (ITG) therapy 1 month after the first instillation.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Single intratympanic treatment with gentamicin has a 59.6% efficacy in vertigo control in the long term. Hearing change in the immediate period after treatment (1 month) is not significant to pre-treatment result and is similar for patients who needed multiple doses due to recurrence. Chronic disequilibrium and the need for vestibular rehabilitation were less frequent in patients with a good control of vertigo with just one single injection of gentamicin. A fair accuracy was obtained for the VOR gain reduction of the horizontal canal (area under the curve = 0.729 in the Receiver Operating Characteristic analysis) in predicting the need for one or more ITG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Single intratympanic treatment with gentamicin is an effective treatment for patients with MD. That modality of treatment has very limited damaging effect in hearing. The degree of vestibular deficit induced by the treatment is significant as measured by the reduction in the gain of the VOR but not useful for prognostic purposes.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fneur.2022.808570","type":"journal-article","created":{"date-parts":[[2022,3,20]],"date-time":"2022-03-20T10:45:03Z","timestamp":1647773103000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":6,"title":["Low-Dose Intratympanic Gentamicin for Unilateral M\u00e9ni\u00e8re\u2018s Disease: Accuracy of Early Vestibulo-Ocular Reflex Gain Reduction in Predicting Long-Term Clinical Outcome"],"prefix":"10.3389","volume":"13","author":[{"given":"Ricardo","family":"Wegmann-Vicu\u00f1a","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raquel","family":"Manrique-Huarte","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Diego","family":"Calavia-Gil","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo","family":"Mart\u00edn-Sanz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pedro","family":"Marques","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Perez-Fernandez","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2022,3,18]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"181","DOI":"10.1016\/S0194-5998(95)70102-8","article-title":"American Academy of Otolaryngology-Head and Neck Foundation, Inc","volume":"113","year":"1995","journal-title":"Otolaryngol Head Neck Surg"},{"key":"B2","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1097\/MAO.0000000000002451","article-title":"Intratympanic Treatment in Meni\u00e8re's Disease, Efficacy of Aminoglycosides Versus Corticosteroids in Comparison Studies: A Systematic Review","volume":"41","author":"Yaz","year":"2020","journal-title":"Otol Neurotol."},{"key":"B3","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1007\/s101620010053","article-title":"Changes in the three-dimensional angular vestibulo-ocular reflex following intratympanic gentamicin for M\u00e9ni\u00e8re's disease","volume":"3","author":"Carey","year":"2002","journal-title":"J Assoc Res Otolaryngol."},{"key":"B4","doi-asserted-by":"publisher","first-page":"544","DOI":"10.1097\/00129492-200407000-00023","article-title":"Intratympanic gentamicin therapy for M\u00e9ni\u00e8re's disease: a meta-analysis","volume":"25","author":"Chia","year":"2004","journal-title":"Otol Neurotol."},{"key":"B5","doi-asserted-by":"publisher","first-page":"1474","DOI":"10.1097\/MLG.0b013e318065aa27","article-title":"Long-term disability of class a patients with M\u00e9ni\u00e8re's disease after treatment with intratympanic gentamicin","volume":"117","author":"Boleas-Aguirre","year":"2007","journal-title":"Laryngoscope."},{"key":"B6","doi-asserted-by":"publisher","first-page":"1443","DOI":"10.1007\/s00405-013-2597-7","article-title":"Intratympanic gentamicin treatment 'as needed' for Meniere's disease. 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