@misc{SmythMossmanWeatheralletal., author = {Smyth, Duncan and Mossman, Stuart and Weatherall, Mark and Jolliffe, Evan and Joshi, Purwa and Taylor, Jennifer and Thorne, Katie and Watson, Eloise and Leadbetter, Ruth and Mossman, Benjamin and Moss, Tawhai and Todd, Nicholas Sean and Schneider, Erich}, title = {Gentamicin vestibulotoxicity with modern systemic dosing regimens : a prospective study using videooculography}, series = {Acta Oto-Laryngologica}, volume = {139}, journal = {Acta Oto-Laryngologica}, number = {9}, doi = {10.1080/00016489.2019.1637935}, pages = {759 -- 768}, abstract = {Objectives: To determine the incidence of gentamicin vestibulotoxicity with current dosing regimens, and to evaluate the feasibility of routine video-oculography on all patients given gentamicin. Materials and methods: In this prospective incidence study serial horizontal vestibulo-ocular reflex (HVOR) gain measurements were recorded using video-oculography on adult inpatients receiving intravenous gentamicin. The primary outcome was the proportion of patients developing impairment of their HVOR gain. Results: After exclusions, 42 patients were included in the analysis. Three patients (7.1\%) developed asymptomatic vestibulotoxicity, exact 95\% confidence interval 1.5-19.5\%. In two of these patients the deficit resolved within several hours. No patients developed symptomatic vestibulotoxicity. There was no evidence for a generalised reduction in group HVOR gain with time. HVOR gain was not associated with total gentamicin dose, dynamic visual acuity or subjective imbalance. Conclusions and significance: Gentamicin may cause reversible, asymptomatic vestibulotoxicity. Video-oculography may be useful to monitor for vestibulotoxicity in patients treated with gentamcin; however, testing all patients routinely may be challenging.}, language = {en} }