title: Intratympanic dexamethasone as a symptomatic treatment for Ménière's disease.
abstract: OBJECTIVE
  Determine whether intratympanic (IT) dexamethasone, when given on an as needed basis, can successfully control Ménière's disease (MD) symptoms in a large percentage of patients and allow them to avoid ablative therapies.
  
  
  METHODS
  Retrospective chart review.
  
  
  METHODS
  Tertiary medical center.
  
  
  METHODS
  One hundred fifty-nine patients met the American Academy of Otolaryngology-Head and Neck Surgery criteria for unilateral definitive MD. All patients failed dietary and medical therapy and received at least one IT dexamethasone treatment by one of 4 otologists in an academic center.
  
  
  METHODS
  IT dexamethasone.
  
  
  METHODS
  Patients were determined to be treatment failures if they did not achieve satisfactory control of their symptoms with IT dexamethasone and chose another treatment modality. Treatment success was defined as IT dexamethasone providing control of MD symptoms to the degree that they did not require any other further treatment modalities.
  
  
  RESULTS
  Successful avoidance of ablative surgery was achieved in 81.1% of patients with greater than 24 months of follow-up. No statistically significant associations were found related to age, sex, laterality, or duration of symptoms. For each IT dexamethasone perfusion sequence, there was a 20.0% increase in likelihood of successful treatment (OR, 1.20; 95% CI, 1.01-1.40; p = 0.01).
  
  
  CONCLUSIONS
  IT dexamethasone is a successful adjuvant treatment for Ménière's disease in patients on medial therapy and dietary restrictions.
authors.affiliation: *Department of Otolaryngology-Head and Neck Surgery, and †Department of Biostatistics, School of Medicine and Nursing, Vanderbilt University Medical Center, Nashville, Tennessee, U.S.A.
authors.forename: Theodore R
authors.initials: TR
authors.lastname: McRackan
authors.forename: Jennifer
authors.initials: J
authors.lastname: Best
authors.forename: Elizabeth C
authors.initials: EC
authors.lastname: Pearce
authors.forename: Marc L
authors.initials: ML
authors.lastname: Bennett
authors.forename: Mary
authors.initials: M
authors.lastname: Dietrich
authors.forename: George B
authors.initials: GB
authors.lastname: Wanna
authors.forename: David S
authors.initials: DS
authors.lastname: Haynes
authors.forename: Robert F
authors.initials: RF
authors.lastname: Labadie
mesh_terms: D000328:Adult; D000368:Aged; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage*; D003907:Dexamethasone / Q000008:administration & dosage*; D005260:Female; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy*; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome; D014432:Tympanic Membrane / Q000187:drug effects
chemical_list: D000893:Anti-Inflammatory Agents; D003907:Dexamethasone