Response Over Time of Vertigo Spells to Intratympanic Dexamethasone Treatment in Meniere’s Disease Patients

Abstract

OBJECTIVE:To assess the effectiveness and response over time of intratympanic dexamethasone on the symptoms of Meniere's disease. MATERIALS and METHODS:We performed a matched cohort study of 24 patients with Meniere's disease who were unresponsive to initial treatment and underwent 3 sessions of weekly intratympanic dexamethasone injections using a concentration of 16 mg/mL and 24 matched controls with the same characteristics with regard to vertigo spells. RESULTS:Compared with control subjects, intratympanic dexamethasone injections resulted in a decrease in the frequency of vertigo spells in the first 6-month period. In the dexamethasone-treated group, a ≥60% decrease in vertigo spells was achieved by 70.8% of patients in the first 6 months. Total remission was achieved by 20.8% of patients in the first 8 months, but after this, the effect tapered. A slight improvement in Tinnitus loudness and no changes in hearing levels were found. The stage of Meniere's disease, years from disease onset, and mean number of vertigo spells per month did not have any effects on the percentage of decrease in vertigo spells. CONCLUSION:Intratympanic dexamethasone temporarily reduces the frequency of vertigo spells during the initial months but does not remove the probability of having further spells in the future. This therapy provides a valuable tool to accomplish a rapid decrease in vertigo spells in subjects with Meniere's disease, and it is considered an alternative to chemical or surgical labyrinthectomy.

A comparison of endolymphatic shunt surgery and intratympanic gentamicin for meniere's disease

“…35 While additional studies also support the effectiveness of intratympanic steroids in the treatment of MD, 32,36 others have shown a transient or lack of vertigo control following intratympanic steroids, and controversies remain regarding the efficacy of this treatment. 32,[37][38][39] To date, no studies comparing intratympanic steroid injections to ELS have been published. In our study, only one patient from each group received intratympanic steroids prior to ELS or ITG.…”

Local inner ear application of dexamethasone in cochlear implant models is safe for auditory neurons and increases the neuroprotective effect of chronic electrical stimulation

“…DEX has been intensively investigated in clinical studies for its biological effects if applied intratympanically (e.g. [ 2 , 3 , 21 , 56 , 57 ]). However, it is not possible to calculate the intra-cochlear doses that were achieved in those studies based on the information given on applied concentrations, volumes and treatment regimen.…”

“…Glucocorticoids, especially dexamethasone (DEX), are in the researchers and clinicians focus. Next to clinical studies investigating its effect on cisplatin-induced hearing loss [ 1 ], Mènière’s disease [ 2 , 3 ], tinnitus [ 4 ], and sudden idiopathic sensorineural hearing loss [ 5 , 6 ] DEX is intensively used in cochlear implant optimization research on fibrosis reduction and residual hearing preservation [ 7 – 11 ].…”

A network-based method using a random walk with restart algorithm and screening tests to identify novel genes associated with Menière's disease

“…Therefore, the drug choices rely mainly on diverse symptoms. For example, if nausea and vomiting are main symptoms of MD patients, an antiemetic may be an optimal choice for treatment to avoid vomiting [ 15 ]. However, for the patients with severe vertigo symptoms, a diuretic, which contributes to the output of urine, may be the best choice for treatment [ 16 ].…”