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PubMed2002

Visual vestibular mismatch in patients treated with intratympanic gentamicin for Meniere's disease.

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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