Treatment of vestibular disorders

At our department, we generally perform inner ear anesthesia with lidocaine and intratympanic dexamethasone injection for treatment of patients with Menière's disease or labyrinthine vertigo due to circulatory disturbances of the inner ear, having failed other conservative treatments. These treatments were performed in 322 patients who consulted us during the past 7 years, including 136 patients with Menière's disease and 186 patients with labyrinthine vertigo. The criteria for evaluation of the therapeutic effect included the AAOO (1972), the AAO-HNS (1985) and Sakata's (1987) method. Both therapeutic methods were effective not only for the inhibition of vertiginous attacks, but also for the treatment of tinnitus. In the overall evaluation of therapeutic effect, dexamethasone injection was more effective than inner ear anesthesia in cases of Menière's disease whereas inner ear anesthesia was more effective than dexamethasone injection in cases of labyrinthine vertigo. When the three methods of evaluation were compared, the rate of positive effect increased in this order: the AAOO method showed fewer positive effects than the AAO-HNS method, and fewer than or equal to Sakata's method. For example in cases of Menière's disease that are resistant to drug therapy, these two therapeutic methods appear to be worthwhile before attempting surgical treatment for refractory vertigo.