Benefits of pre-labyrinthectomy intratympanic gentamicin: contralateral vestibular responses

Objective To determine the impact of pre-operative intratympanic gentamicin injection on the recovery of patients undergoing translabyrinthine resection of vestibular schwannomas. Methods This prospective, case–control pilot study included eight patients undergoing surgical labyrinthectomy, divided into two groups: four patients who received pre-operative intratympanic gentamicin and four patients who did not. The post-operative six-canal video head impulse test responses and length of in-patient stay were assessed. Results The average length of stay was shorter for patients who received intratympanic gentamicin (6.75 days; range, 6–7 days) than for those who did not (9.5 days; range, 8–11 days) ( p = 0.0073). Additionally, the gentamicin group had normal post-operative video head impulse test responses in the contralateral ear, while the non-gentamicin group did not. Conclusion Pre-operative intratympanic gentamicin improves the recovery following vestibular schwannoma resection, eliminating, as per the video head impulse test, the impact of labyrinthectomy on the contralateral labyrinth.