Objective To determine the impact of preoperative intratympanic gentamycin injection on patients
undergoing translabyrinthine resection of vestibular schwannomas (VS).
Methods This is a case comparison pilot study of eight patients undergoing translabyrinthine
resection of VS. Group 1 consisted of four patients who did not receive preoperative
intratympanic gentamycin and group 2 consisted of four patients who received preoperative
intratympanic gentamycin. All patients underwent postoperative six-canal video head
impulse test (vHIT); the patients from group 2 also underwent pre- and postinjection
six-canal vHIT. We looked into the length of inpatient stay, their recovery, and the
contralateral semicircular canal function.
Results The average postoperative length of stay in the patients who did not receive intratympanic
gentamycin was 9.5 days, while in those who did, it was only 6.5 days. All patients
achieved good balance results with the nongentamycin group requiring more time. Additionally,
the gentamycin group had normal postoperative vHIT results in the contralateral ear,
while the nongentamycin group had abnormal vHIT results in at least one contralateral
semicircular canal. Of note, in those patients who received intratympanic injections,
the middle ear was noted to have some mild fibrosis, a finding of no clinical significance.
Conclusion Our pilot study demonstrates that preoperative gentamycin ablation of the labyrinth
may benefit patients undergoing VS resection. Additionally, we show for the first
time the impact of the translabyrinthine resection on the contralateral side and how
this is eliminated by the preoperative gentamycin injections.
