Hearing and Vestibular Function After Preoperative Intratympanic Gentamicin Therapy for Vestibular Schwanomma as Part of Vestibular Prehab.

Objective: To evaluate auditory and vestibular function after presurgical treatment with gentamicin in schwannoma patients. Background: The vestibular PREHAB protocol aims at diminishing the remaining vestibular function before vestibular schwannoma surgery, to ensure less acute symptoms from surgery, and initiate a more efficient vestibular rehabilitation already before surgery. However, the potential cochleotoxicity of gentamicin is a concern, since modern schwannoma surgery strives to preserve hearing. Study design: Retrospective study. Setting: University hospital. Patients: Seventeen patients diagnosed with vestibular schwannoma between 2004 and 2011, and took part in vestibular PREHAB program. The patients were of age 21 to 66 years (mean 48.8), 9 females and 8 males. Intervention: Intratympanic gentamicin installations before surgery as part of the vestibular PREHAB. Main outcome measures: Hearing thresholds, word recognition score, caloric response, subjective visual vertical and horizontal, cVEMP, and vestibular impulse tests. Results: Combined analysis of frequency and hearing threshold showed a significant decrease after gentamicin therapy (p

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