Transtympanic steroids for Ménière's disease

Area of Science:

• Otolaryngology
• Neurology
• Pharmacology

Background:

• Ménière's disease (MD) is a chronic inner ear disorder characterized by vertigo, tinnitus, and hearing loss.
• Current treatments for MD aim to manage symptoms and improve quality of life, but long-term efficacy remains a focus of research.
• Transtympanic steroids (TTS) offer a localized treatment approach for inner ear conditions.

Purpose of the Study:

• To evaluate the long-term effectiveness of transtympanic steroids (TTS) using methyl-prednisolone for Ménière's disease (MD).
• To assess the impact of TTS on hearing, tinnitus, and vertigo spells over a 24-month period.

Main Methods:

• A descriptive prospective study involving 34 patients diagnosed with probable or definitive MD.
• Patients received three consecutive doses of TTS (methyl-prednisolone).
• Outcomes measured included pure-tone average (PTA), tinnitus annoyance (visual analog scale), and vertigo spell frequency at 12 and 24 months.

Main Results:

• After 12 months, 48% of patients showed a PTA improvement of ≥10 dB (average 8.6 dB). Tinnitus relief was reported by 81.5%, and vertigo spells reduced from 4.3 to 0.3 (81% vertigo-free).
• At 24 months, 33.3% had PTA improvement ≥10 dB (average 3.3 dB, nonsignificant). Tinnitus relief was achieved by 78%, and vertigo spells reduced to 0.5 (78% vertigo-free).
• 35.2% required retreatment, and 6.25% needed transtympanic gentamicin for persistent vertigo.

Conclusions:

• Transtympanic steroids (TTS) demonstrated good hearing preservation in MD patients.
• TTS provided significant tinnitus control (over 70%) and dramatic reduction in vertigo spells (over 90%) at 24 months.
• TTS represents a viable long-term treatment option for managing Ménière's disease symptoms.