Control of vertigo in Ménière's disease by intratympanic dexamethasone

Weckel, Alexandra; Marx, Mathieu; Estève-Fraysse, M.-J.

doi:10.1016/j.anorl.2017.07.002

Cited by 14 publications

(22 citation statements)

References 17 publications

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“…They found that 23% of patients were free of vertigo at the end of 24 months after IT steroids, but there was no significant improvement in hearing. These results are in accordance with those from Weckel et al 23 who retrospectively evaluated 25 patients treated with IT dexamethasone; they reported a satisfactory control of vertigo in 92% of the patients, and this protocol achieved control of vertigo in 70% of patients at 2 years. Harcourt et al 24 suggested IT methylprednisolone as an effective treatment for the long-term control of vertigo attacks, without he known inner-ear toxicity associated with gentamicin.…”

Section: Discussionsupporting

confidence: 91%

Pharmacological, surgical and diagnostic innovations in Meniere’s disease: a review

Scarpa

Ralli²,

Bonis

et al. 2020

Translational Medicine @ UniSa

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Meniere's disease is an inner ear disorder characterized by the presence of endolymphatic hydrops in the inner ear and symptomatology of recurrent and debilitating vertigo attacks, tinnitus, aural fullness, and fluctuating sensorineural hearing loss. Although many therapeutic options for MD have been proposed during years, no consensus has been reached by the scientific community. In the last decade, many therapeutic options have been proposed, as intratympanic steroid, intratympanic gentamicin, and intravenous glycerol. Recently, the role of the antisecretory factor in the diet of MD patients have been investigated. Surgery is recommended for intractable MD; some authors proposed new approaches including transcanal endoscopic infracochlear vestibular neurectomy, new marsupiliazation technique in sac surgery, and tenotomy of the stapedius and tensor tympani muscles.

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Section: Discussionsupporting

confidence: 91%

Pharmacological, surgical and diagnostic innovations in Meniere’s disease: a review

Scarpa

Ralli²,

Bonis

et al. 2020

Translational Medicine @ UniSa

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“…Other AQPs have been suspected to be involved in the pathogenesis of MD, showing a likely key-role of this type of membrane channels in the pathophysiology of MD [65][66][67] . Beside the evidence of AQP role in the endolymph homeostasis, corticosteroids (which have been shown effective in the treatment of MD [24][25][26][27] ) have already been suspected to act through AQP function, in particular by upregulating mRNA of AQP1 68 , or AQP 3 known to be crucial in the reabsorption of water in the inner ear 69 .…”

Section: Figure 8 Putative Mechanism For Spontaneous Interaction Betw...mentioning

confidence: 99%

“…This approach has shown significant benefits in the treatment of MD [24][25][26][27] . Several mechanisms of action have been put forward to explain the effect of dexamethasone in the treatment of MD, such as an anti-inflammatory effect as in the context of acute peripheral vestibulopathy, or a direct modulation of fluid fluxes at the base of the EH formation 26,[28][29][30] . However, none of these hypotheses have so far been substantiated theoretically and verified by experiment.…”

Section: Introductionmentioning

confidence: 99%

Dexamethasone, a direct modulator of AQP2 in Menière’s disease

Mom

Robert-Paganin

Mom

et al. 2022

Preprint

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Menière s disease is a chronic illness characterized by intermittent episodes of vertigo associated with fluctuating sensorineural hearing loss, tinnitus and aural pressure. This pathology strongly correlates with a dilatation of the fluid compartment of the endolymph, so-called hydrops. Dexamethasone is one of the therapeutic approaches recommended when conventional antivertigo treatments have failed. Several mechanisms of actions have been hypothesized for the mode of action of dexamethasone such as anti-inflammatory effect or as a regulator of the inner ear water homeostasis. However, none of them have been experimentally confirmed so far. Aquaporins (AQPs) are transmembrane water channels and are hence central in the regulation of trans-cellular water fluxes. In the present study we investigated the hypothesis that dexamethasone could impact water fluxes in the inner ear through direct interaction with AQP2. We addressed this question through molecular dynamics simulations approaches and managed to demonstrate a direct interaction between AQP2 and dexamethasone and its significant impact on the channel water permeability. We also describe the molecular mechanisms involved in dexamethasone binding and in its regulatory action upon AQP2 function

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“…It achieves control of vertigo in 70% of patients at 2 years. 16,17 11. Drugs with Probable Efficacy…”

Section: Steroidsmentioning

confidence: 99%

Scrupulously managing vertigo

Chaudhry¹

2021

JPBS

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Vertigo is a sense of spinning dizziness. There is no ideal medicine for treatment of vertigo and dizziness. The duration of dizziness/vertigo: attacks may last for seconds or minutes (as in vestibular paroxysm) or hours (as in Menière’s disease or vestibular migraine). Diagnosis and treatment of vertigo remains a challenge for many physicians. Many drugs produce dizziness and vertigo side effects such as some antibiotics , diuretics, mucolytics and NSAIDs. Symptoms of Vertigo are usually managed with vestibular suppressants. Steroids are useful in selected patients. Neurosurgical treatment is chosen in lesions such as hematomas, tumors, vascular lesions, pathology of the cervical spine (cervicalspondylopathy)

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Control of vertigo in Ménière's disease by intratympanic dexamethasone

Abstract: Dexamethasone is part of the management strategy for patients with Ménière's disease refractory to conventional treatment, implemented before destructive treatment. It achieves control of vertigo in 70% of patients at 2 years.

Cited by 14 publications

References 17 publications

Pharmacological, surgical and diagnostic innovations in Meniere’s disease: a review

Pharmacological, surgical and diagnostic innovations in Meniere’s disease: a review

Dexamethasone, a direct modulator of AQP2 in Menière’s disease

Scrupulously managing vertigo

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