title: Control of vertigo after intratympanic corticoid therapy for unilateral Ménière's disease: a comparison of weekly versus daily fixed protocols.
abstract: OBJECTIVE
  This study aimed to evaluate the long-term effects of intratympanic corticoid therapy on vertigo control and hearing changes.
  
  
  METHODS
  The study design was retrospective.
  
  
  METHODS
  Tertiary medical centers.
  
  
  METHODS
  Fifty-six patients with definite unilateral Ménière's disease, diagnosed using the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) guidelines, were included. Twenty-two patients were treated with a fixed protocol of 3 consecutive daily intratympanic injections of a 4 mg/ml dexamethasone commercial preparation. Thirty-four patients were treated with a fixed protocol of 3 consecutive weekly injections of the same preparation.
  
  
  METHODS
  The 1995 AAO-HNS criteria for reporting treatment outcome in MD were used. The treatment results were expressed in terms of vertigo control. A Kaplan-Meier analysis was used to evaluate the control of vertigo over a 2-year period. Separate curves were created depending on the protocol used and the class of vertigo control obtained.
  
  
  RESULTS
  Complete vertigo control (class A) was achieved in 40.9% and 44.1% of patients on the daily and weekly protocols, respectively. Substantial vertigo control was obtained in an additional 18.2% and 14.7% of patients on the daily and weekly protocols, respectively. No significant differences were found between the 2 fixed protocols.
  
  
  CONCLUSIONS
  Intratympanic dexamethasone (4 mg/ml) perfusion provides an alternative treatment for definite Ménière's disease. The Kaplan-Meier analysis was useful for analyzing the control of vertigo and the recurrence of Ménière's disease.
authors.affiliation: *Department of Otolaryngology, University Hospital of Getafe Madrid; and †Department of Otolaryngology, University Hospital Casa de Salud, Valencia, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Martin Sanz
authors.forename: Christiane
authors.initials: C
authors.lastname: Zschaeck
authors.forename: Zschaeck Luzardo
authors.initials: ZL
authors.lastname: Christiane
authors.forename: Manuel
authors.initials: M
authors.lastname: Gonzalez
authors.forename: Gonzalez Juliao
authors.initials: GJ
authors.lastname: Manuel
authors.forename: Teresa
authors.initials: T
authors.lastname: Mato
authors.forename: Mato Patino
authors.initials: MP
authors.lastname: Teresa
authors.forename: Laura
authors.initials: L
authors.lastname: Rodrigañez
authors.forename: Rodrigañez Riesco
authors.initials: RR
authors.lastname: Laura
authors.forename: Rafael
authors.initials: R
authors.lastname: Barona
authors.forename: Rafael Barona
authors.initials: RB
authors.lastname: De Guzmán
authors.forename: Ricardo
authors.initials: R
authors.lastname: Sanz
authors.forename: Sanz Fernandez
authors.initials: SF
authors.lastname: Ricardo
mesh_terms: D000328:Adult; D001301:Audiometry, Pure-Tone; D003907:Dexamethasone / Q000008:administration & dosage / Q000627:therapeutic use*; D004334:Drug Administration Schedule; D005260:Female; D005938:Glucocorticoids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane; D014717:Vertigo / Q000188:drug therapy*
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone