Intratympanic Injection of Dexamethasone and Electrocochleographic Data in Cases of Definite One Sided Refractory Meniere’s Disease

Document Type : Original

Authors

1 Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.

2 Department of Audiology, School of Rehabilitation, Tehran University of Medical Sciences, Tehran, Iran.

3 Department of Audiology, University of Social Welfare and Rehabilitation, Tehran, Iran.

Abstract

Introduction:
Meniere’s disease (MD) is a disease of the inner ear that presents itself with repeated episodes of vertigo (96.2%), tinnitus (91.1%), and sensorineural hearing loss (87.7 %). In this article we sought to assess the effects of intratympanic (IT) injections of dexamethasone on definite cases of MD using electrocochleography (ECOG).
Materials and Methods:
In this hospital-based case series in 36 patients, we measured audiometric values and ECOG in all patients before, 1 month and 6 months after 4-mg/mL IT injections of dexamethasone.
Results:
Four patients (11%) had improved hearing following the intervention. No difference in pure tone audiometry (PTA) was observed following IT injections (P=0.492), while speech discrimination score (SDS) was significantly improved (P=0.008). There was a significant improvement in vertigo 1 month after IT injections (P<0.001), although this effect did not last for 6 months. No significant change in ECOG was observed between before and after treatment (P=0.052).
Conclusion:
IT dexamethasone injections can improve vertigo in definite cases of MD, although it seems that the effect is only temporary.

Keywords

Main Subjects

References

1. Flint PW, Haughey BH,Lund VJ, Niparko JK,Richardson MA, Robbins KT,et al. Cummings Otolaryngology Head and Neck Surgery.5thed. Philadelphia: Mosby; 2010.
2. Ferraro JA, Tibbils RP. SP/AP area ratio in the diagnosis of Meniere's disease. Am J Audiol. 1999; 8(1):21–8.
3.Silverstein H, Isaacson JE, Olds MJ, Rowan PT, Rosenberg S. Dexamethasone inner ear perfusion for the treatment of Meniere's disease: a prospective, randomized, double-blind, crossover trial. Am J Otol. 1998;19(2):196–201.
4.Chandrasekhar SS, Rubinstein RY, Kwartler JA, Gatz M, Connelly PE, Huang E, et al. Dexamethasone pharmacokinetics in the inner ear: comparison of route of administration and use of facilitating agents. Otolaryngol Head Neck Surg. 2000; 122(4):521-8.
5.Martin-Sanz E, Esteban-Sanchez J, Rodrigañez-Riesco L, Sanz-Fernández R. Transitory effect on endolymphatic hydrops of the intratympanic steroids for Ménière's disease. Laryngoscope. 2015; 125(5): 1183–8.
6.Barrs DM. Intratympanic corticosteroids for Meniere's disease and vertigo. OtolaryngolClin North America. 2004;37(5):955–72.
7.Barrs DM, Keyser JS, Stallworth C, McElveen JT, Jr. Intratympanic steroid injections for intractable Meniere's disease. Laryngoscope. 2001; 111(12):2100–4.
8.Martin-Sanz E, Luzardo CZ, Riesco LR, Patino TM, Sanz R. The use of electrocochleography to monitor the response of Meniere's disease patients to intratympanic steroids. ActaOtolaryngol. 2013; 133(11):1158–64.
9.Herraiz C, Plaza G, Aparicio JM, Gallego I, Marcos S, Ruiz C. Transtympanic steroids for Meniere's disease. OtolNeurotol 2010;31(1):162–7.
10.Martin-Sanz E, Esteban Sanchez J, Gonzalez Juliao M, ZschaeckLuzardo C, MatoPatino T, RodriganezRiesco L, et al. [Extratympanicelec- trocochleography in Meniere's disease]. ActaOtorrinolaringol Espanola. 2012; 63(6):421–8.
11. Daneshi A, Mohamadi S, Emamgomeh H, forotan AR. The Study of Electrocochleography and ABR in 100 Patients with Menier’s Disease InHazratRasoul Hospital, 1998–2000. Razi J Med Sci. 2002;8(27):563–6.
Iranian Journal of Otorhinolaryngology
Volume 29, Issue 3 - Serial Number 92
May and June 2017
Pages 121-125

Files

Share

How to cite

Statistics