title: Issues, indications, and controversies regarding intratympanic steroid perfusion.
abstract: OBJECTIVE
  Office-based intratympanic inner ear steroid perfusion (ITPs) treatment for Ménière's disease, autoimmune inner ear disease, and sudden sensorineural hearing loss has been expanding over the past 10-15 years, yet remains controversial. The purpose of this review is to examine the current literature of basic science and human studies of ITPs treatment.
  
  
  RESULTS
  Animal studies exist regarding the delivery, distribution, biochemical, and microbiological changes in the inner ear post ITPs. However, few clinical studies exist on ITPs treatment in sudden sensorineural hearing loss and even less in treating Ménière's disease. There are no consistent studies regarding drug delivery methods, type, and concentration of steroids. Moreover, there are no studies comparing ITPs results to the natural history of Ménière's disease.
  
  
  CONCLUSIONS
  ITPs has impacted otology and neurotology practice due to increased utilization. A sound understanding of the basic science and clinical studies is needed to establish long-term efficacy of ITPs in controlling hearing loss in Ménière's disease by comparison to its natural history, as well as, potential application to other disorders.
authors.affiliation: The Cleveland Hearing & Balance Center, Cleveland, Ohio 44122, USA. hamidma@ClevelandHearingBalance.com
authors.forename: Mohamed
authors.initials: M
authors.lastname: Hamid
authors.forename: Dennis
authors.initials: D
authors.lastname: Trune
mesh_terms: D000818:Animals; D015331:Cohort Studies; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D016503:Drug Delivery Systems; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000188:drug therapy*; D003639:Hearing Loss, Sudden / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D036502:Infusions, Intralesional; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis / Q000188:drug therapy*; D011379:Prognosis; D018570:Risk Assessment; D013256:Steroids / Q000008:administration & dosage* / Q000009:adverse effects; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000187:drug effects*
chemical_list: D013256:Steroids
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