Pre-operative intratympanic gentamicin in patients undergoing retrosigmoid resection of large vestibular schwannomas: a pilot study

Purpose To assess the effects of intratympanic gentamicin on the recovery of patients with large vestibular schwannomas undergoing retrosigmoid resection.Methods We conducted a prospective case-control pilot study over 24 months, including 13 patients with large vestibular schwannomas (25-41 mm intracranial diameter); seven patients received intratympanic gentamicin pre-operatively, while six did not. Outcome measures were duration of stay (main), age, gender, vestibular schwannoma size, body mass index and financial costs.Results Age had the highest association with longer inpatient stay. The non-gentamicin patients had longer hospital stays, were older, had lower body mass indices and larger vestibular schwannomas. A trend towards shorter stay was seen in patients receiving gentamicin with tumours less than 35 mm in size, but not in patients with larger tumours. Costs were lower for the gentamicin group.Conclusion Although not statistically significant, there was a positive trend in patients with vestibular schwannomas greater than 35 mm in size; thus, intratympanic gentamicin as prehabilitation could be considered.