title: Response Over Time of Vertigo Spells to Intratympanic Dexamethasone Treatment in Meniere's Disease Patients.
abstract: OBJECTIVE
  To assess the effectiveness and response over time of intratympanic dexamethasone on the symptoms of Meniere's disease.
  
  
  METHODS
  We performed a matched cohort study of 24 patients with Meniere's disease who were unresponsive to initial treatment and underwent 3 sessions of weekly intratympanic dexamethasone injections using a concentration of 16 mg/mL and 24 matched controls with the same characteristics with regard to vertigo spells.
  
  
  RESULTS
  Compared with control subjects, intratympanic dexamethasone injections resulted in a decrease in the frequency of vertigo spells in the first 6-month period. In the dexamethasone-treated group, a ≥60% decrease in vertigo spells was achieved by 70.8% of patients in the first 6 months. Total remission was achieved by 20.8% of patients in the first 8 months, but after this, the effect tapered. A slight improvement in Tinnitus loudness and no changes in hearing levels were found. The stage of Meniere's disease, years from disease onset, and mean number of vertigo spells per month did not have any effects on the percentage of decrease in vertigo spells.
  
  
  CONCLUSIONS
  Intratympanic dexamethasone temporarily reduces the frequency of vertigo spells during the initial months but does not remove the probability of having further spells in the future. This therapy provides a valuable tool to accomplish a rapid decrease in vertigo spells in subjects with Meniere's disease, and it is considered an alternative to chemical or surgical labyrinthectomy.
authors.affiliation: Department of Otolaryngology, Hospital Universitario La Fe, Valencia, Spain. nabil_atrache@hotmail.com.
authors.forename: Nabil
authors.initials: N
authors.lastname: Atrache Al Attrache
authors.forename: Claudio
authors.initials: C
authors.lastname: Krstulovic
authors.forename: Vanesa
authors.initials: V
authors.lastname: Pérez Guillen
authors.forename: Constantino
authors.initials: C
authors.lastname: Morera Pérez
authors.forename: Herminio
authors.initials: H
authors.lastname: Pérez Garrigues
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003907:Dexamethasone / Q000008:administration & dosage*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D000069555:Injection, Intratympanic; D008297:Male; D008575:Meniere Disease / Q000175:diagnosis* / Q000188:drug therapy*; D008875:Middle Aged; D012008:Recurrence; D014012:Tinnitus / Q000175:diagnosis / Q000188:drug therapy; D014724:Vestibular Function Tests
chemical_list: D003907:Dexamethasone