title: [Clinical evaluation of intratympanic methylprednisolone perfusion for intractable Meniere's disease].
abstract: OBJECTIVE
  To evaluate the clinical efficacy of the intratympanic methylprednisolone perfusion for patients of intractable Meniere's disease (MD).
  
  
  METHODS
  Ten cases (10 ears), collected from Janu 2008 to Janu 2010, of intractable MD were studied retrospectively. The micro-catheter was placed into the tympanum of the affected ear, then methylprednisolone was imported into the tympanum once a day for 10 days. The average followed-up duration was (15. 4 +/- 5. 4) months after the perfusion. The treatment effect of vertigo, hearing loss and activity capacity was evaluated with Diagnostic Criteria for MD set by the Guiyang Meeting in 2006. The efficacy of tinnitus was analyzed by comparing the score of tinnitus handicap inventory (THI) before and after treatment.
  
  
  RESULTS
  The vertigo was absolutely controlled in 7 patients (grade A), partially controlled in 2 patients (grade B) and no efficiency in 1 patient (grade C). The 2 patients in grade B had a vertigo again in 9 months and 11 months after intratympanic perfusion, respectively, while the frequency, severity and duration of their vertigo softened obviously. Puretone threshold average (PTA) at the affected frequencies was decreased to within the level of 20 dB in one patient and was improved more than 30 dB in another one (grade A), improved 15 dB to 30 dB in 4 patients (grade B), and improved less than 15 dB in the other 4 patients. The average score of THI was 48.80 +/- 7.25 and 41.9 +/- 7.78 before and after perfusion respectively. The ability capacity of all the 10 patients after treatment was as normal (grade A), i. e. All of them could lead an independent life. There was no irreversible tympanic perforation in the operated ear and there was no other complications left.
  
  
  CONCLUSIONS
  Intratympanic methylprednisolone perfusion through the micro-catheter is a safe and effective method for the intractable Meniere's disease.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, the Affiliated Drum Tower Hospital, Nanjing University Medical School, Nanjing, 210008, China.
authors.forename: Ling
authors.initials: L
authors.lastname: Lu
authors.forename: Yanhong
authors.initials: Y
authors.lastname: Dai
authors.forename: Wandong
authors.initials: W
authors.lastname: She
authors.forename: Chenjie
authors.initials: C
authors.lastname: Yu
authors.forename: Feng
authors.initials: F
authors.lastname: Chen
authors.forename: Junguo
authors.initials: J
authors.lastname: Wang
authors.forename: Xiaofeng
authors.initials: X
authors.lastname: Ma
authors.forename: Xiaoming
authors.initials: X
authors.lastname: Qin
authors.forename: Xia
authors.initials: X
authors.lastname: Gao
mesh_terms: D004432:Ear, Middle; D005260:Female; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy*; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000627:therapeutic use; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D008775:Methylprednisolone