Presented as a poster presentation at the Southern Section Meeting of The Triological Society, Marco Island, FL, January 12, 2001.
Intratympanic Steroid Injections for Intractable Ménière's Disease†
Article first published online: 2 JAN 2009
Copyright © 2001 The Triological Society
Volume 111, Issue 12, pages 2100–2104, December 2001
How to Cite
Barrs, D. M., Keyser, J. S., Stallworth, C. and McElveen, J. T. (2001), Intratympanic Steroid Injections for Intractable Ménière's Disease. The Laryngoscope, 111: 2100–2104. doi: 10.1097/00005537-200112000-00003
- Issue published online: 2 JAN 2009
- Article first published online: 2 JAN 2009
- Manuscript Accepted: 21 AUG 2001
- Meniere's disease;
- intratympanic steroids;
- steroid installation surgery
Objective To examine whether intratympanic injection of dexamethasone is effective in controlling vertigo in patients with Ménière's disease who have persistent vertigo despite standard medical treatment, including a low-salt/no-caffeine diet and diuretics.
Study Design A prospective study.
Methods From August 1999 to November 2000, 21 patients with intractable Ménière's disease underwent intratympanic injections of 4 mg/mL dexamethasone over a period of 4 weeks as an office procedure. American Academy of Otolaryngology–Head and Neck Surgery guidelines for the definition and reporting of results in Ménière's disease were used. 1
Results Complete relief of vertigo was maintained in 11 of the 21 patients (52%) at 3 months and in 9 of 21 patients (43%) at 6 months. Repeat injections in 5 patients who had initial control of vertigo, but later failed, yielded control in 3 (60%) patients. The complication rate was low: one patient had a 35-decibel pure tone average decrease in hearing during treatment and one patient had a persistent tympanic membrane perforation.
Conclusions Intratympanic injections of dexamethasone are a reasonable initial surgical treatment for persistent vertigo in Ménière's disease. The principal benefits are avoidance of systemic administration of steroids, lower cost than endolymphatic sac surgery, and ease of administration as an office procedure. The disadvantages are the need for repeated office visits for injections and the decreasing effectiveness over time.