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    Does betahistine treatment have additional benefits to vestibular rehabilitation?
    (Springer, 2010) Karapolat, Hale; Celebisoy, Nese; Kirazli, Yesim; Bilgen, Cem; Eyigor, Sibel; Gode, Sercan; Akyuz, Aycan; Kirazli, Tayfun
    The aim of this study was to investigate the effect of high-dose betahistine treatment added to vestibular rehabilitation (VR) on the disability, balance and postural stability in patients with unilateral vestibular disorder. The VR group (group 1, n = 24) and the VR + betahistine group (group 2, n = 23) were analyzed retrospectively. All patients were evaluated before and after an 8-week customized VR in terms of disability (Dizziness Handicap Inventory, DHI), dynamic balance [Dynamic Gait Index (DGI)] and postural stability (static posturography). In group 1 and group 2, differences between DHI, DGI and falling index score on static posturography before and after the exercise program were significant (p < 0.05). In addition, a significant difference was detected only in group 2 in the variables evaluated in static posturography-Fourier 4 analysis (p < 0.05). Both VR and betahistine + VR have a positive effect on disability and balance in patients with unilateral vestibular disorder. Betahistine treatment added to VR was effective in increasing postural stability.
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    Single-shot, low-dose intratympanic gentamicin in Meniere disease: role of vestibular-evoked myogenic potentials and caloric test in the prediction of outcome
    (W B Saunders Co-Elsevier Inc, 2011) Gode, Sercan; Celebisoy, Nese; Akyuz, Aycan; Gulec, Feray; Karapolat, Hale; Bilgen, Cem; Kirazli, Tayfun
    Objective: The aim of this study was to assess the efficacy and safety of single and low-dose intratympanic gentamicin therapy in patients with Meniere disease and who were monitored both with caloric tests and vestibular-evoked myogenic potentials (VEMPs) to see if VEMPs have an additional role in predicting the efficacy of the drug. Study design: This is a prospective cohort study. Setting: Tertiary referral center is the study setting. Patients: Twenty-five intractable Meniere disease patients were included as the study group. Intervention(s): Low-dose (16 mg/mL), single-shot intratympanic gentamicin was applied. VEMP and caloric test were applied 2 weeks after the application. Main outcome measure(s): Safety and efficacy of protocol were evaluated at the sixth month postoperatively with tonal audiogram and visual analog scale, respectively. Results: Mean average pure-tone hearing threshold at 0.5, 1, 2, 4, and 8 kHz was 49.6 and 51.0 dB before and after the application, respectively (P > .05). Mean pretreatment and posttreatment visual analog scale scores of patients were 17.6 mm (10-30 mm) and 74.6 mm (41-100 mm), respectively (P < .01). Posttreatment VEMPs were absent in 17, deteriorated in 2, and not changed in 6 patients. VEMP was a significant predictor of posttreatment visual analog scale score, whereas caloric test was not (P < .01). Conclusions: Low-dose, single-shot intratympanic gentamicin treatment proved to be effective and safe among intractable Meniere patients. VEMPs obtained at posttreatment second week were significant predictors of patients posttreatment sixth-month dizziness status and vertigo control. (C) 2011 Elsevier Inc. All rights reserved.