Results
During the procedure patients complained of a bearable pain, comparable
to an intramuscular injection. In the 6 months prior to treatment,
patients reported a mean frequency of six vertigo attacks per
month(range 2–12). Pre-treatment median PTA was 48 dB(IQR 44-52) and
median unilateral caloric weakness was 42% (IQR 32-57). In 98.6% of
the patients(n=71) the ITG produced full remission of vertiginous
symptoms. In 91.6% of cases(n=66) a single treatment(three consequent
injections) was sufficient to control vertigo, in 5.5% of cases(n=4)
two treatments were necessary to control vertigo( in 2 patients 1 year
after first treatment; in 1 patients 2 year after first treatment; in 1
patient 9 year after first treatment) and in 1.3% of patients(n=1)
three treatments were necessary to control vertigo(4 years and 6 years
after first ITG). Number of gentamicin injections applied to achieve
vertigo control is shown in Fig.1. In the unsuccessful patient we have
repeated ITG treatment five times (1, 3, 6 and 7 years after first ITG)
without full control on the vertigo symptoms and, however, without
significantly hearing impairment( pre-treatment PTA=51.25;
post-treatment PTA=52.5; t-value=0.65; The p -value is 0.26). In
no case we have had hearing loss after ITG procedure. Post-treatment PTA
was 49.2dB(IQR 44-54). The difference between pre and post treatment PTA
was no statistical difference at p<0.05(t-value=-12.1;
p-value< .00001). Mean post-treatment unilateral caloric
weakness was 78%(IQR 48-88). The difference between pre- and
post-treatment value was statistically significant at
p<0.05(t-value=0.40; p-value=0.34). In all cases the same
procedure was performed (three following daily ITG of 40 mg/ml
concentration). All patients of the study group complained imbalance
after gentamicin procedure which resolved 1 to 2 months after the IGT
without a specific vestibular rehabilitation, rather we recommend
patients to practice light physical activity (such as walking) as soon
as possible.