Chemical perfusion of the inner ear

Role of Intratympanic Steroids in the Management of Meniere’s Disease—A Review of 151 Cases

“…Vertigo control rate was 98.01% [148 patients]. Jackson and Silverstein et al found that control of vertigo with intratympanic steroids was excellent-rivaling other prominent surgical treatments and concluded that intratympanic therapy can become the most prominent first line treatment for Meniere's disease [15].…”

Metilprednisolona intratimpânica como terapia de resgate na surdez neurossensorial súbita

“…Other authors have also described the use of intratympanic corticosteroids for the treatment of SHL. 9,[12][13][14][15][16][17][18][19][20][21][23][24][25][26][27] Although its efficacy alone has not been proved definitively, intratympanic corticosteroid therapy for SHL is becoming more widely used. The variability among treatment protocols for SHL also applies to intratympanic corticosteroid therapy.…”

“…13,15,16 Most studies about intratympanic corticosteroids for treating SHL report having attempted this mode of therapy after systemic corticosteroid therapy has failed. 9,[12][13][14][15][16][17][18][19][20][21][25][26][27] Two studies evaluated the effects of intratympanic corticosteroids as adjuvant therapy to systemic corticosteroids in SHL patients. 23,24 There are several advantages of using intratympanic corticosteroids (see Frame I).…”

“…Dexamethasone is the most common steroid used intratympanically, 14,15,[18][19][20][21]24,25 followed by methylprednisolone. 9,13,15,16,17,23,26,27 Reports in the literature differ about the concentration of solutions (dexamethasone: 2-4 mg/mL 14,20 to 25 mg/mL; 15 methylprednisolone 32 mg/mL 23 to 62.5 mg/mL).…”

“…Administration modes also differ: transtympanic needle injection, 9,13,15,19,20,17,[24][25][26][27] myringotomy, 13,14 myringotomy with a ventilation tube, 12,23 myringotomy with a special perfusion needle (Micromedics, Eagan, MN), 18,21 and implantable infusion pumps in the middle ear (Round Window m-Cath; Durect Corp., Cupertino, CA) for continuous steroid release. 16,17,21 The duration of treatment, the interval between injections, and the number of injections also differs among authors, ranging from a single dose to weekly transtympanic injections, 9,12,14,15,18,20,23 steroid solutions as drops applied by patients during several weeks, 18,21 transtympanic injections several times a week, 19,23,25,26 or implantable infusion pumps. 16,17,21 Reported complications are rare, and include pain, 13 vertigo, 13,16,17,20,21 otitis media, 13 perforated tympanic membrane, 9,21 acne, 20 dysgeusia, …”