Skull-vibration-induced nystagmus test in patients who are candidates for intratympanic gentamicin injection.

IF 2.1 4区医学 Q2 OTORHINOLARYNGOLOGY Acta Otorhinolaryngologica Italica Pub Date : 2023-04-01 DOI:10.14639/0392-100X-N2152

Giacomo Ciacca, Alfredo Di Giovanni, Luigi Califano, Vito Enrico Pettorossi, Giampietro Ricci, Chiara Pelliccia, Mario Faralli

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Abstract

Objective: This study aims to evaluate the utility of the skull-vibration-induced nystagmus test (SVINT) in the selection of patients with Ménière's disease (MD) for intratympanic injection of gentamicin. To date the indications for this treatment have been based only on subjective elements.

Methods: A retrospective study was performed in 20 patients diagnosed with unilateral MD. SVINT were performed monthly and the evoked responses were evaluated. After 6 months, the results from patients who were candidates for gentamicin treatment (G group) were compared with those who did not need it (nG group). Correlation with Dizziness Handicap Inventory (DHI) score was evaluated.

Results: 120 tests were performed. Positive SVINTs were identified in 52 cases (43.3%) and included excitatory nystagmus in 18 (34.7%), inhibitory nystagmus in 28 (53.8%), and atypical pattern in 6 cases (11.5%). A significant increase excitatory nystagmus was recorded in group G (p = 0.00001). Moreover, there was a significant increase in the DHI score in group G compared with the nG group (p < 0.0001) and in patients with evoked excitatory nystagmus.

Conclusions: The finding of excitatory nystagmus during SVINTs performed on several occasions in the follow-up prior to intratympanic injection of gentamicin strengthens this therapeutic choice.

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鼓膜内庆大霉素注射候选患者的颅骨振动诱发眼球震颤试验。

目的:探讨震动诱发眼球震颤试验(SVINT)在选择鼓膜内注射庆大霉素患者中的应用价值。迄今为止，这种治疗的适应症仅基于主观因素。方法:对20例诊断为单侧MD的患者进行回顾性研究，每月进行SVINT，并评估诱发反应。6个月后，将庆大霉素候选治疗组(G组)与不需要庆大霉素治疗组(nG组)的结果进行比较。评估与头晕障碍量表(DHI)评分的相关性。结果:共进行了120次试验。svint阳性52例(43.3%)，其中兴奋性眼球震颤18例(34.7%)，抑制性眼球震颤28例(53.8%)，非典型眼球震颤6例(11.5%)。G组兴奋性眼球震颤显著增加(p = 0.00001)。此外，与nG组和诱发性兴奋性眼球震颤患者相比，G组的DHI评分显著升高(p < 0.0001)。结论:在鼓室内注射庆大霉素之前进行的几次svint随访中发现兴奋性眼球震颤，加强了这种治疗选择。

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来源期刊

Acta Otorhinolaryngologica Italica OTORHINOLARYNGOLOGY-

CiteScore

3.40

自引率

10.00%

发文量

审稿时长

6-12 weeks

期刊介绍： Acta Otorhinolaryngologica Italica first appeared as “Annali di Laringologia Otologia e Faringologia” and was founded in 1901 by Giulio Masini. It is the official publication of the Italian Hospital Otology Association (A.O.O.I.) and, since 1976, also of the Società Italiana di Otorinolaringoiatria e Chirurgia Cervico-Facciale (S.I.O.Ch.C.-F.). The journal publishes original articles (clinical trials, cohort studies, case-control studies, cross-sectional surveys, and diagnostic test assessments) of interest in the field of otorhinolaryngology as well as clinical techniques and technology (a short report of unique or original methods for surgical techniques, medical management or new devices or technology), editorials (including editorial guests – special contribution) and letters to the Editor-in-Chief. Articles concerning science investigations and well prepared systematic reviews (including meta-analyses) on themes related to basic science, clinical otorhinolaryngology and head and neck surgery have high priority.