Hostname: page-component-586b7cd67f-dsjbd Total loading time: 0 Render date: 2024-11-26T01:26:05.771Z Has data issue: false hasContentIssue false
  • English
  • Français

Long-term effects of intratympanic methylprednisolone perfusion treatment on intractable Ménière's disease

Published online by Cambridge University Press:  06 February 2015

W She ,
L Lv ,
X Du ,
H Li ,
Y Dai ,
L Lu ,
X Ma  and
F Chen
W She*
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Nanjing Drum Tower Hospital of Nanjing University Medical School, Jiangsu, China
L Lv
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Huai'an First People's Hospital, Nanjing Medical University, Jiangsu, China
X Du
Affiliation:
Hough Ear Institute, Oklahoma City, Oklahoma, USA
H Li
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Nanjing Drum Tower Hospital of Nanjing University Medical School, Jiangsu, China
Y Dai
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Nanjing Drum Tower Hospital of Nanjing University Medical School, Jiangsu, China
L Lu
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Nanjing Drum Tower Hospital of Nanjing University Medical School, Jiangsu, China
X Ma
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Nanjing Drum Tower Hospital of Nanjing University Medical School, Jiangsu, China
F Chen
Affiliation:
Department of Otolaryngology–Head and Neck Surgery, Nanjing Drum Tower Hospital of Nanjing University Medical School, Jiangsu, China
*
Address for correspondence: Dr W She, Department of Otolaryngology–Head and Neck Surgery, Nanjing Drum Tower Hospital of Nanjing University Medical School, 321 Zhongshan Road, Nanjing 210008, China Fax: 86–25–83317016 E-mail: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

Objective:

This study aimed to investigate the long-term efficacy of intratympanic methylprednisolone perfusion treatment for intractable Ménière's disease.

Methods:

A retrospective analysis of 17 intractable Ménière's disease patients treated with intratympanic methylprednisolone perfusion was performed. Treatment efficacy was evaluated according to the American Academy of Otolaryngology–Head and Neck Surgery criteria. Short and long-term control or improvement rates were calculated after 6 and 24 months, respectively.

Results:

Sixteen patients were followed for more than two years. Short- and long-term vertigo control rates were 94 per cent and 81 per cent, respectively; short- and long-term functional activity improvements were 94 per cent and 88 per cent, respectively. The pure tone average was 53 ± 14 dB before treatment, and 50 ± 16 dB at 6 months and 52 ± 20 dB at 24 months after intratympanic methylprednisolone perfusion. Tinnitus was controlled or improved in five patients over the two-year follow-up period.

Conclusion:

Intratympanic methylprednisolone perfusion can effectively control vertigo and improve functional activity in intractable Ménière's disease patients with good hearing preservation. It may therefore be a viable alternative treatment for intractable Ménière's disease.

Keywords

Ménière's diseaseMethylprednisolonePerfusionTympanum
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Issue 3 , March 2015 , pp. 232 - 237
Copyright
Copyright © JLO (1984) Limited 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Gabra, N, Saliba, I. The effect of intratympanic methylprednisolone and gentamicin injection on Ménière's disease. Otolaryngol Head Neck Surg 2013;148:642–7Google Scholar
2Boleas-Aguirre, MS, Lin, FR, Della Santina, CC, Minor, LB, Carey, JP. Longitudinal results with intratympanic dexamethasone in the treatment of Ménière's disease. Otol Neurotol 2008;29:33–8Google Scholar
3Kitahara, T, Fukushima, M, Uno, A, Imai, T, Ohta, Y, Morihana, T et al. Long-term results of endolymphatic sac drainage with local steroids for intractable Meniere's disease. Auris Nasus Larynx 2013;40:425–30Google Scholar
4Sajjadi, H, Paparella, MM. Meniere's disease. Lancet 2008;372:406–14Google Scholar
5Pullens, B, van Benthem, PP. Intratympanic gentamicin for Ménière's disease or syndrome. Cochrane Database Syst Rev 2011;(16):CD008234Google Scholar
6Casani, AP, Piaggi, P, Cerchiai, N, Seccia, V, Franceschini, SS, Dallan, I. Intratympanic treatment of intractable unilateral Meniere disease: gentamicin or dexamethasone? A randomized controlled trial. Otolaryngol Head Neck Surg 2012;146:430–7Google Scholar
7Sajjadi, H. Medical management of Ménière's disease. Otolaryngol Clin North Am 2002;35:581–9Google Scholar
8Herraiz, C, Plaza, G, Aparicio, JM, Gallego, I, Marcos, S, Ruiz, C. Transtympanic steroids for Ménière's disease. Otol Neurotol 2010;31:162–7CrossRefGoogle ScholarPubMed
9Parnes, LS, Sun, AH, Freeman, DJ. Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope 1999;109:1–17CrossRefGoogle ScholarPubMed
10Committee on Hearing and Equilibrium. Committee on Hearing and Equilibrium guidelines on for the diagnosis and evaluation of therapy for Meniere's disease. Otolaryngol Head Neck Surg 1995;113:181–5CrossRefGoogle Scholar
11She, W, Dai, Y, Du, X, Yu, C, Chen, F, Wang, J et al. Hearing evaluation of intratympanic methylprednisolone perfusion for refractory sudden sensorineural hearing loss. Otolaryngol Head Neck Surg 2010;142:266–71Google Scholar
12Itoh, A, Sakata, E. Treatment of vestibular disorders. Acta Otolaryngol Suppl 1991;481:617–23CrossRefGoogle ScholarPubMed
13Rupprecht, R, Reul, JM,Van Steensel, B, Spengler, D, Söder, M, Berning, B et al. Pharmacological and functional characterization of human mineralocorticoid and glucocorticoid receptor ligands. Eur J Pharmacol 1993;247:145–54Google Scholar
14Smith, PJ, Cousins, DJ, Jee, YK, Staynov, DZ, Lee, TH, Lavender, P. Suppression of granulocyte macrophage colony stimulating factor expression by glucocorticoids involves inhibition of enhancer function by the glucocorticoid receptor binding to composite NF-AT/activator protein-1 elements. J Immunol 2001;167:2502–10Google Scholar
15Garduño-Anaya, MA, Couthino De Toledo, H, Hinojosa-González, R, Pane-Pianese, C, Ríos-Castañeda, LC. Dexamethasone inner ear perfusion by intratympanic injection in unilateral Ménière's disease, a two-year prospective, placebo-controlled, double-blind, randomized trial. Otolaryngol Head Neck Surg 2005;133:285–94Google Scholar
16Phillips, JS, Westerberg, B. Intratympanic steroids for Ménière's disease or syndrome. Cochrane Database Syst Rev 2011;(6):CD008514Google Scholar
17Belinchon, A, Perez-Garrigues, H, Tenias, JM, Lopez, A. Hearing assessment in Menière's disease. Laryngoscope 2011;121:622–6Google Scholar
18Semaan, MT, Zheng, QY, Han, F, Zheng, Y, Yu, H, Heaphy, JC et al. Characterization of neuronal cell death in the spiral ganglia of a mouse model of endolymphatic hydrops. Otol Neurotol 2013;34:559–69CrossRefGoogle ScholarPubMed
19Peterson, WM, Isaacson, JE. Current management of Ménière's disease in an only hearing ear. Otol Neurotol 2007;28:696–9Google Scholar