title: Transitory effect on endolymphatic hydrops of the intratympanic steroids for Ménière's disease.
abstract: OBJECTIVE
  This study aimed to evaluate the changes in electrocochleography (EcohG) measurements after intratympanic (IT) dexamethasone therapy and to correlate them with the long-term effects on the control of vertigo.
  
  
  METHODS
  Prospective outcomes research.
  
  
  METHODS
  This study included 62 patients with unilateral Ménière's Disease (MD) refractory to medical therapy for at least 1 year. Each patient was treated with a fixed protocol of three consecutive weekly injections of a commercial 4 mg/mL dexamethasone preparation. The 1995 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) criteria for reporting treatment outcomes for MD were used. Electrocochleography (EcohG) measurements were performed 1 month before and 1 and 12 months after IT steroid therapy. Caloric test and vestibular evoked myogenic potential (VEMPs) were performed before the IT treatment. The summating potential/action potential (SP/AP) ratio was measured before and after the IT treatment. A Kaplan-Meier analysis was used to evaluate the control of vertigo over a 2-year period.
  
  
  RESULTS
  Complete vertigo control (class A) was achieved in 26 patients (41.9%) at the 12-month follow-up and in 12 patients (19.3%) at the 24-month follow-up. A significant reduction (P < 0.01) in the SP/AP ratio after the IT steroid treatment was observed in the first-month determination, but no significant differences were found when the initial and 12-month determination were compared.
  
  
  CONCLUSIONS
  IT dexamethasone provides an alternative treatment for patients with Ménière's Disease. A transitory reduction of the endolymphatic hydrops is detected by the EcohG 1 month after treatment. The hydrops levels returned to their initial values in the 1-year EcohG follow-up.
  
  
  METHODS
  2b.
authors.affiliation: Department of Otolaryngology, University Hospital of Getafe, Madrid, Spain.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Martin-Sanz
authors.forename: Jonathan
authors.initials: J
authors.lastname: Esteban-Sanchez
authors.forename: Laura
authors.initials: L
authors.lastname: Rodrigañez-Riesco
authors.forename: Ricardo
authors.initials: R
authors.lastname: Sanz-Fernández
mesh_terms: D001300:Audiometry, Evoked Response; D003907:Dexamethasone / Q000008:administration & dosage; D004432:Ear, Middle; D018159:Endolymphatic Hydrops / Q000188:drug therapy; D005260:Female; D005500:Follow-Up Studies; D005938:Glucocorticoids / Q000008:administration & dosage*; D006801:Humans; D008297:Male; D008575:Meniere Disease / Q000188:drug therapy*; D008875:Middle Aged; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D005938:Glucocorticoids; D003907:Dexamethasone
keywords: Kaplan-Meier; Ménière's disease; electrocochleography; endolymphatic hydrops; intratympanic steroids