Visual vestibular mismatch in patients treated with intratympanic gentamicin for Meniere’s disease
Abstract
OBJECTIVE: To support the hypothesis that the symptom complex known as visual vestibular mismatch (VVM) can be induced by peripheral vestibular disease. DESIGN: Retrospective chart review; prospective questionnaire. SETTING: A tertiary/quaternary care hospital clinic. METHODS: The charts of 28 patients who were treated for Meniere's disease were studied. Their responses to a pretreatment VVM questionnaire were scored and compared with their answers in a telephone follow-up to the same questions posttreatment. These questionnaires were compared with those filled in by 100 control patients without ear disease. MAIN OUTCOME MEASURES: Patients' responses to a VVM-specific questionnaire. RESULTS: Seventeen of 28 patients had VVM. Gentamicin therapy increased the number of positive answers. There was no correlation between the development of VVM complaints, caloric scores, and posturography performance. No control patients had symptoms of VVM. CONCLUSION: We conclude that the development of VVM indicates the onset or worsening of vestibular disease as it can be induced or exacerbated by gentamicin therapy. As there is no correlation between VVM and caloric scores, we suggest that otolithic damage may be responsible for this symptom set developing.
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Environments that contain full field visual flow, large complex patterns, or wide-open spaces with distant or indistinct visuospatial reference points are most troublesome for patients with PPPD.
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“, large fields, warehouses, atria) are most troublesome [15, 29, 39, 43, 50, 63, 75].”
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“Question-naires designed to assess VV include the Situational Characteristics Questionnaire [23, 37, 45], the Lon-gridge and Mallinson interview questions [28, 29, 32], the Pediatric Visually Induced Dizziness Questionnaire [33], and the Visual Vertigo Analogue Scale (VVAS) [12, 13].”
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“[8, 15,16]) outlining that gentamicin therapy does not require absolute destruction of a labyrinth, but monitoring of progression of caloric weakness is imperative.”
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- Authors
- Longridge, N. S., Mallinson, A. I., & Denton, A.
- Affiliations
- Vancouver Hospital and Health Sciences Centre (CA)
- ORCID
- Mallinson, Arthur I.
- Venue
- The Journal of Otolaryngology
- Publisher
- Decker Medicine
- Published
- 2002
- Volume
- 31
- Issue
- 01
- Pages
- 5
- ISSN
- 0381-6605 (ISSN-L)
- OpenAlex
- W1989181262
- Cited by
- 48
- References
- 0
- Citations by year
- 2025: 3 · 2024: 2 · 2023: 2 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 3 · 2017: 4 · 2016: 3 · 2015: 3 · 2014: 1 · 2013: 3 · 2012: 1
- FWCI
- 1.07
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Otolaryngology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Life Sciences › Neuroscience › Neurology › Vestibular and auditory disorders
- Health Sciences › Medicine › Surgery › Nausea and vomiting management
- Life Sciences › Neuroscience › Sensory Systems › Hearing, Cochlea, Tinnitus, Genetics
- Keywords
- visual-vestibular mismatch, Meniere's disease, intratympanic gentamicin, gentamicin ototoxicity, peripheral vestibular disorders, caloric test, posturography, dizziness
- MeSH terms
- Anti-Bacterial Agents, Caloric Tests, Ear, Middle, Female, Follow-Up Studies, Gentamicins, Humans, Male, Meniere Disease, Prospective Studies, Retrospective Studies, Severity of Illness Index, Time Factors, Visual Perception, Vestibular Diseases
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