Tổng quan hệ thống nghiên cứu không kiểm soát được công bố cho thấy rằng gentamicin làm giảm chức năng tiền đình ở tai được điều trị và đạt được kiểm soát chóng mặt tổng thể kiểm soát đầy đủ hoặc đáng kể trong 89% bệnh nhân (từ 73-100%); nghe trở nên tồi tệ hơn trong 26% | Treatment In the daily practice it is useful to administer vestibular sedatives such as dimenhydrinate during acute self-limiting attacks 11 15 18 . One popular prophylactic treatment regimen tries to reduce the endolymph by low-salt diet or diuretics another option is to administer betahistine 8-16mg day . Higher dosages up to 3 X 48 mg seem to be more effective than lower ones 15 although the efficacy of betahistine has not been proven 18 No randomized studies on these treatment options have yet been conducted. A retrospective survey of the outcome of 22 patients revealed that intratympanic steroid perfusion was only of short-term benefit 19 . A systematic review of published uncontrolled studies found that gentamicin reduced vestibular function in the treated ear and achieved overall vertigo control complete or substantial control in 89 of the patients range 73-100 hearing worsened in 26 0-90 20 . A meta-analysis examined the application of gentamicin which poses the lowest risk of hearing loss 21 . The titration technique with daily or weekly doses until onset of vestibular symptoms change in vertigo or hearing loss showed the best rate of vertigo control. Complete ablation of the vestibular function is not typically required for such control 21 as this is also not achieved for a long time with gentamicin instillation 22 . Superior Canal Dehiscence Syndrome Clinical Aspects Patients with a so-called superior canal dehiscence syndrome 23 24 complain of vertigo and oscillopsia which are induced by intense sound stimuli a Valsalva maneuver or in some cases even the heart beat when nystagmus beats synchronously with the pulse in the plane of the involved vestibular canal 25 . The accompanying jerk nystagmus has vertical and torsional components 23 24 . Etiology The superior canal dehiscence syndrome is a special form of inner-ear perilymph fistula 23 . High-resolution computed tomography has shown that the cause is a missing bone coverage between the superior canal
