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Intratympanic steroid injections for intractable Ménière's disease.
D M Barrs1, J S Keyser, C Stallworth
1Carolina Ear and Hearing Clinic, Raleigh, North Carolina 27609, USA. barrs@carolinaear.com
The Laryngoscope
|January 22, 2002
Summary
Intratympanic dexamethasone injections effectively control vertigo in Ménière
Area of Science:
- Otolaryngology
- Neurology
Background:
- Ménière's disease causes debilitating vertigo.
- Standard treatments like diet and diuretics are often insufficient for persistent symptoms.
Purpose of the Study:
- To evaluate the efficacy of intratympanic dexamethasone injections for vertigo in Ménière's disease patients with refractory symptoms.
Main Methods:
- Prospective study involving 21 patients with intractable Ménière's disease.
- Intratympanic dexamethasone (4 mg/mL) administered over 4 weeks as an office procedure.
- Results assessed using American Academy of Otolaryngology-Head and Neck Surgery guidelines.
Main Results:
- Complete vertigo relief in 52% at 3 months and 43% at 6 months.
- Repeat injections achieved control in 60% of previously responsive patients.
- Low complication rate, with two reported adverse events.
Conclusions:
- Intratympanic dexamethasone is a viable initial treatment for persistent Ménière's disease vertigo.
- Offers advantages over systemic steroids, endolymphatic sac surgery (cost, administration).
- Requires repeated visits; effectiveness may decrease over time.