Control of vertigo in Ménière's disease by intratympanic dexamethasone

Eur Ann Otorhinolaryngol Head Neck Dis. 2018 Feb;135(1):7-10. doi: 10.1016/j.anorl.2017.07.002. Epub 2017 Jul 29.

Abstract

Objective: The main objective was to assess the efficacy of intratympanic dexamethasone injection in controlling vertigo in unilateral Ménière's disease refractory to medical treatment.

Materials and methods: A retrospective study included 25 patients with disabling unilateral Ménière's disease, defined according to the American Academy of Otorhinolaryngology-Head and Neck Surgery (AAO-HNS) criteria. Patients received intratympanic dexamethasone during the monitoring period. Control of vertigo was classified according to AAO-HNS vertigo control index, at 6 months, 1 year, and 2 years after treatment initiation. Complications and progression of hearing were also assessed.

Results: Satisfactory control (class A or B) was obtained in 92% of patients (n=23/25) at 6 months, 68% (n=17/25) at 1 year, and 70% (n=16/23) at 2 years. There was no worsening of hearing in those patients who were well-controlled by this therapeutic strategy. No local or systemic complications were observed during follow-up.

Conclusion: Dexamethasone is part of the management strategy for patients with Ménière's disease refractory to conventional treatment, implemented before destructive treatment. It achieves control of vertigo in 70% of patients at 2 years.

Keywords: Dexamethasone; Intratympanic; Ménière's disease; Vertigo.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Audiometry, Pure-Tone / methods
  • Dexamethasone / administration & dosage*
  • Female
  • Follow-Up Studies
  • Glucocorticoids / administration & dosage*
  • Hearing*
  • Humans
  • Injection, Intratympanic / methods
  • Male
  • Meniere Disease / drug therapy*
  • Middle Aged
  • Retrospective Studies
  • Treatment Outcome

Substances

  • Glucocorticoids
  • Dexamethasone