Author Topic: Gentamicin injections prior to surgery  (Read 3039 times)

lisab66

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Gentamicin injections prior to surgery
« on: August 12, 2016, 09:53:07 am »
My doc Is recommending I have a gentamicin injection prior to my surgery. Has anyone gone this route?  How bad was the vertigo after it?  Thanks. I'm new to this whole AN thing!  My appointment is schedule for next week Wednesday and need so feedback prior!
« Last Edit: August 13, 2016, 02:19:53 pm by lisab66 »

ANGuy

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Re: Gentamicin injections prior to surgery
« Reply #1 on: August 12, 2016, 03:40:28 pm »
Your vestibular nerve will be cut during surgery.  This will result in zero balance function coming from the AN side.  This sudden change (loss) of balance function is what brings about the symptoms of vertigo and dizzyness and nausea. 

Right now, that particular vestibular nerve in your head is compromised by the tumor.  The balance function on that side is less than 100%.  The closer that level of function is to 100% at the time of surgery, the greater the sudden change (loss) in function when it is cut and brought to 0%.

So, if your vetibular nerve is already pretty bad off, the change from surgery will be relatively small and therefore your dizziness etc after surgery will be minimal since your brain is already adjusted to the low balance function on that side.

There are tests to see where the nerve is at in terms of function.  It may be pointless to get a gentamicin injection if the function on that side is basically destroyed already.

Gentamicin destroys the function of the chochlea.  The chochlea has two chambers, one for balance and one for hearing.  There is a possibility that the injection could destroy the hearing section of the chochlea as well.  If there is a chance of preserving your hearing through surgery, then find out the risk to your hearing that the injection could pose.

One way or other, your balance function will be gone on that side.  If a gentamicin injection bringing this about before surgery will make recovery easier is dependent on your current level of function on that side.  In my case, my Dr told me my balance function was pretty much gone and would slowly decline while I Watch and Wait, therefore, if and when I eventually get surgery, any dizziness etc would be minimal.

Gentamicin will kill that function and getting that out of the way may be a very good idea.  The injection is a simple process.  There is the risk to your hearing, but I don't know how much of a concern that is and you should find that out.

Diagnosed June 2014 1cm AN at 47 years of age.  Had fluctuating symptoms since 2006.    6 mos MRI (Dec 2014) showed no growth, MRI  in July 2015 showed no growth.  MRI Jan 2016 showed no growth.  MRI Aug 2016 showed no growth.  I'm gonna ride the WW train as long as I can.

lisab66

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Re: Gentamicin injections prior to surgery
« Reply #2 on: August 12, 2016, 05:23:01 pm »
My balance is off, but not terrible. I have no vertigo at this point and have lost almost more the 75% hearing on that side already. Just trying to weigh the options if going through the vertigo before of after. Financially if it really bad I can afford to be out of work until my surgery 9/27!
« Last Edit: August 13, 2016, 02:20:52 pm by lisab66 »

UpstateNY

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Re: Gentamicin injections prior to surgery
« Reply #3 on: August 12, 2016, 10:47:17 pm »
lisab66,

You can have tests performed to help determine how much function is currently left in your vestibular nerves.  Please note that there are two vestibular nerve branches, the superior (uppper) vestibular nerve and the inferior (lower) vestibular nerve.  As per my physician, the caloric test can be used to test the superior vestibular nerve and the VEMP can be used to test the inferior vestibular nerve.

Gentamicin has a pretty long list of possible side effects, so I believe its use should be carefully considered.

My AN was relatively small (~15mm at surgery) and the only balance issue I had prior to surgery was some lightheadedness when moving.  Post surgery I had no worse balance than prior to surgery.  I woke up in the ICU with no vertigo at all.  Only the caloric test was available in my area and had shown some weakness in my AN ear.  We suspect if the VEMP test was performed it would have shown a high level of weakness in the AN ear, especially since the AN originated from the inferior vestibular nerve.
Apr 2015: Diagnosed with 8mm AN at age 49
Oct 2015: MRI showed growth to 12mm
Feb 2016: Completely removed via Transcochlear approach at House Clinic; no facial/eye issues, balance improved
Aug 2016: MRI shows no regrowth/residual tumor

My story:  http://www.anausa.org/smf/index.php?topic=22581.0