title: Intratympanic dexamethasone injections for refractory Meniere' s disease.
abstract: Intratympanic injections or titration is a potential medical therapeutic strategy for patients with incurable inner ear diseases. Dexamethasone represent an attractive steroid source in intratympanic steroids strategies in the treatment of inner ear disorders. Here, we evaluated the effectiveness of intratympanic dexamethasone injections (IDI) in outpatients with refractory Meniere's disease (MD). Vestibular function measured by Vestibular Ocular Reflex (VOR) gain and caloric test revealed that 21 outpatients out of 43 (48.8%) had complete sufficient vertigo control, while 9 (20.9%) of them were attached to fundamental manipulation. Out of the 13 remaining outpatients, 4 (9.3%) had a limit control and 9 had less modification. Therefore, 5 of 9 received re-treatment with IDI and 2 of 9 patients were administered ablative treatment with gentamicin. Meanwhile, audiology data suggested that 3 (7.0%), 4 (9.3%), 32 (74.4%), 4 (9.3%) patients were attached to the level of A, B, C, D, respectively. Furthermore, the symptom of tinnitus in 5 outpatients vanished, 21 (48.8%) diminished, 10 (23.3%) invariable, 7 (16.3%) aggravated. In 4 of 24 cases (16.7%), aural fullness disappeared after IDI, when the aural fullness was alleviated in 11 cases (45.8%) even intensive in 9 patients (37.5%). Together, our results demonstrate that intratympanic dexamethasone injection, as an effective therapeutic strategy for refractory Meniere's disease, could either be used for cascade therapy preoperation or used for patients who couldn't accept the surgery.
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University Changsha 410011, China.
authors.forename: Hongmiao
authors.initials: H
authors.lastname: Ren
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University Changsha 410011, China.
authors.forename: Tuanfang
authors.initials: T
authors.lastname: Yin
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University Changsha 410011, China.
authors.forename: Yongde
authors.initials: Y
authors.lastname: Lu
authors.affiliation: Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology 1277 Jiefang Avenue, Wuhan 430022, China.
authors.forename: Weijia
authors.initials: W
authors.lastname: Kong
authors.affiliation: Department of Otolaryngology Head and Neck Surgery, The Second Xiangya Hospital, Central South University Changsha 410011, China.
authors.forename: Jihao
authors.initials: J
authors.lastname: Ren
keywords: Meniere’s disease; aural fullness; dexamethasone; gentamicin; intratympanic dexamethasone injections (IDI); intratympanic gentamicin injections; intratympanic injections; refractory; sensorineural hearing loss (SNHL); tinnitus