Res Vestib Sci.  2020 Mar;19(1):22-28. 10.21790/rvs.2020.19.1.22.

A Case of Tumarkin Otolithic Crisis Treated with Intratympanic Gentamicin Injection

• Joo SH
• Kim HJ
• Kim HJ
• Kim KS

• KMID: 2502073
• DOI: http://doi.org/10.21790/rvs.2020.19.1.22

Abstract

Tumarkin otolithic crisis is an abrupt attack of falling without loss of consciousness because of peripheral vestibular disorders. It occurs without warning in patients with late stage or end-stage of Meniere’s disease. It is an otologic emergency due to the risk of fall down injury, and has been treated with labyrinthectomy, vestibular neurectomy, and intratympanic gentamicin injection. Many reports have reported the efficacy of intratympanic injection of gentamicin (ITIG) as chemical ablation. We report a 58-year-old man with Tumarkin otolothic crisis from Meniere’s disease who presented with sudden drop attack while driving a taxi. He has suffered from recurrent rotatory vertigo accompanied by fluctuating hearing loss and tinnitus in the right ear for years. Despite medical treatment over the next 2 months, he experienced three more sudden drop attacks. He got chemical ablation with ITIG and remains without sudden drop attack until fourteen months later. Tumarkin otolithic crisis is a life-threatening otologic emergency. What we have experienced in this case is that for the safety and quality of life of the patient who suffers from Tumarkin otolithic crisis, aggressive vestibular function ablation with high dose ITIG is necessary.

Keyword

Tumarkin otolithic crisis; Meniere’s disease; 메니에르병; 이석발작; 겐타마이신