Intratympanic Therapies for Menière's disease

There are multiple treatment options to consider when managing patients with Menière's disease. When conservative measures fail to control symptoms of Menière's disease, escalation of interventions may be required. Targeted drug delivery to the round window with intratympanic injections allows for local application of high concentrations of medications, largely avoiding systemic side effects. Intratympanic steroids have been shown to be effective at controlling vertigo symptoms, with less robust control rates than those seen with the use of intratympanic gentamicin. Dosing strategies have been modified over time to limit the potential for intratympanic gentamicin-induced ototoxicity. The introduction of intratympanic steroids coupled to a polymer designed for sustained round window drug application, may potentially afford improved duration of symptom control. This review evaluates the recent literature over the last year involving intratympanic therapies for Meniere's disease.