Role of Intratympanic Dexamethasone for Intractable Posterior Canal Benign Paroxysmal Positional Vertigo

Area of Science:

• Otolaryngology
• Neurology
• Vestibular Disorders

Background:

• Benign paroxysmal positional vertigo (BPPV) is a common vestibular disorder.
• Most BPPV cases resolve with repositioning maneuvers.
• A subset of patients (3-12.5%) experience persistent symptoms, termed intractable BPPV.

Purpose of the Study:

• To evaluate the efficacy of intratympanic corticosteroids for treating refractory benign paroxysmal positional vertigo.
• To assess the outcomes of intratympanic dexamethasone injections in patients with intractable BPPV.

Main Methods:

• Prospective analysis of patients diagnosed with BPPV between June 2017 and December 2019.
• Patients received repositioning maneuvers followed by intratympanic dexamethasone injections if criteria for intractable vertigo were met.
• Follow-up assessments were conducted to monitor treatment response.

Main Results:

• Four out of 72 patients met criteria for intractable BPPV after at least six repositioning maneuvers.
• All intractable cases involved the posterior semicircular canal.
• Three of the four patients achieved symptom resolution after one to five intratympanic dexamethasone injections.

Conclusions:

• Intratympanic steroids demonstrate encouraging results for refractory BPPV.
• Further investigation via multicenter randomized clinical trials is warranted to confirm efficacy.
• Intratympanic dexamethasone may be a viable treatment option for intractable BPPV.