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Research in Vestibular Science > Volume 9(2); 2010 > Article
Research in Vestibular Science 2010;9(2): 76-79.
겐타마이신으로 치료에 실패한 Tumarkin 이석발작 1예
김영효, 최호석, 김규성, 김영모
인하대학교 의과대학 이비인후과학교실
A Case of Tumarkin Otolithic Crisis: Failed to Treat with Intratympanic Gentamicin Injection
Young Hyo Kim, Hoseok Choi, Kyu Sung Kim, Young Mo Kim
Departments of Otorhinolaryngology-Head and Neck Surgery, Inha University School of Medicine, Incheon, Korea. stedman@inha.ac.kr
ABSTRACT
Tumarkin otolithic crisis is an unusual manifestation of Meniere’s disease that shows sudden falling without loss of consciousness. As a kind of life-threatening otologic emergency due to high risk of injury, the surgical ablation therapy rather than the medical one is preferred. Intratympanic injection of gentamicin (ITIG) is being introduced as a treatment by chemical ablation of vestibular function. The authors report a case of life-threatening Tumarkin otolithic crisis in 76-year-old female, after onset of Meniere’s disease, failed to treat with multiple application of ITIG, and successfully eradicated the symptom with total labyrinthectomy after then. Also we introduce her clinical feature of Tumarkin otolithic crisis. A 76-year-old female visited clinic suffering from recurrent rotatory vertigo accompanied with fluctuating hearing loss and tinnitus on her left ear, and diagnosis of Meniere’s disease was made. Four months after medical treatment, the patient experienced sudden drop attack during walking on the street without any prodromes, and her right wrist and skull base were fractured as a result. She denied to got surgery and ITIG was applied. During 1 year after initial drop attack, she experienced 7 times of severe drop attack and 4 times of ITIG, and finally she accepted to get surgery. The patient no longer suffered from drop attack after total labyrinthectomy later. Tumarkin otolithic crisis is an otologic emergency, may cause life-threatening falling. Our experience from this case is that vestibular ablation by surgical method is needed for safety and quality of life of patients.
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