http://ijorl.mums.ac.ir/article_13110.html
Intratympanic dexamethasone/hyaluronic acid had a positive effect on the vertigo of patients with Meniere’s disease
dexamethasone
Novel therapy which uses gelatin sponge particles to help deliver high-dose steroids to the inner ear, relieves vertigo, tinnitus, and hearing loss in refractory Ménière’s disease
https://www.sciencedirect.com/science/article/pii/S1672293018300916
https://www.ncbi.nlm.nih.gov/pubmed/31223300?dopt=Abstract
Autoinflammatory characteristics and short-term effects of delivering high-dose steroids to the surface of the intact endolymphatic sac and incus in refractory Ménière’s disease.
J Otol. 2019 Jun;14(2):40-50
Authors: Zou J
Abstract
Objective: To investigate immune-related genetic background in intractable Meniere’s disease (MD) and the immediate results of a novel therapy by delivering steroids to the surface of the intact endolymphatic sac (ES) and incus in a sustainable manner.
Case report and methods: Candidate genes involved in immune regulation were sequenced using a next-generation sequencing method in a patient with intractable MD. Mutations were confirmed using the Sanger sequencing method. The ES was exposed, and gelatin sponge particles were immersed in high-dose methylprednisolone solution and placed onto the surface of ES. “L”-shaped gelatin sponge strips were immersed in dexamethasone solution and served as a guiding device for the steroids by touching the incus and gelatin sponge particles on the surface of the ES. Gelatin sponge particles immersed in dexamethasone solution were placed around the gelatin sponge strips and sealed using fibrin glue.
Results: Autoinflammation in the refractory MD case was indicated by genotype, including novel heterozygous mutations of PRF1, UNC13D, SLC29A3, ITCH, and JAK3, as well as phenotype. The vertigo was fully relieved immediately after operation. Tinnitus and aural fullness were resolved 3 weeks after operation, whereas hearing improved in 2 mon postoperation. No recurrence was noted during the 5-monfollow-up, and the final MRI supported the novel therapeutic hypothesis.
Conclusion: Autoinflammation was involved in a refractory MD. This novel therapy, which involves the delivery of steroids to the surface of the intact ES and incus, is effective in relieving vertigo and tinnitus and improves hearing function of refractory MD.
PMID: 31223300 [PubMed]
PubMed:31223300
Long Term Outcomes of Intratympanic Dexamethasone in Intractable Unilateral Meniere’s Disease
https://link.springer.com/article/10.1007%2Fs12070-018-1431-3
https://www.ncbi.nlm.nih.gov/pubmed/31750179?dopt=Abstract
Long Term Outcomes of Intratympanic Dexamethasone in Intractable Unilateral Meniere’s Disease.
Long Term Outcomes of Intratympanic Dexamethasone in Intractable Unilateral Meniere’s Disease.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1369-1373
Authors: Pradhan P, Lal P, Sen K
Abstract
To evaluate the long term effect of Intratympanic dexamethasone in intractable Meniere’s disease. 30 patients with refractory Meniere’s disease which did not respond to the standard medical management, were treated with Intratympanic dexamethasone injections. Post treatment hearing outcome and dizziness scores were compared with the pretreatment values respectively. The mean dizziness handicap inventory (DHI) score was reduced from 91.58 (range 80-100) to be 31.00 (p = 0.00) at 3 months of treatment. With the successive follow-up periods, the mean DHI scores were reduced to 51.50, 46.6, and 50.90 at the end of, 6, 12, and 24 months (p = 0.04, 0.35, and 0.49 respectively). Again at the end of 24 months, 23.80% of patients were free of vertigo (p = 0.01). No patient had improvement in the hearing (> 10 dB) in any of the follow-up periods and 6.6% demonstrated deterioration in hearing. There were no major intraoperative or postoperative complications detected. Intratympanic injection of steroid is a safe and effective method for treating intractable Meniere’s disease. Although short term improvement in the vertigo is well documented, still in 23% of the patients were found to be free of vertigo at even the end of 24 months. There was no significant improvement in hearing noticed, either in short term or in long term.
PMID: 31750179 [PubMed]
PubMed:31750179
