Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-23T17:40:45.068Z Has data issue: false hasContentIssue false
  • English
  • Français

Transtympanic dexamethasone application in Ménière's disease: an alternative treatment for intractable vertigo

Published online by Cambridge University Press:  29 June 2007

Levent Sennaroğlu ,
Farzin Mottaghian Dini ,
Gonca Sennaroğlu ,
Bulent Gursel  and
Soner Ozkan
Levent Sennaroğlu*
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Farzin Mottaghian Dini
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Gonca Sennaroğlu
Affiliation:
Department of Audiology and Speech Pathology Section, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Bulent Gursel
Affiliation:
Department of Otolaryngology, Head and Neck Surgery, Hacettepe University Faculty of Medicine, Ankara, Turkey.
Soner Ozkan
Affiliation:
Department of Audiology and Speech Pathology Section, Hacettepe University Faculty of Medicine, Ankara, Turkey.
*
Address for correspondence: Levent Sennaroğlu, M.D., Büklüm Sokak 45/16, Kavaklidere, Ankara 06660, Turkey. Fax: 90-312-3113500
Get access Rights & Permissions [Opens in a new window]

Abstract

The aetiology of Ménière's disease still remains unknown and its therapy is therefore empirical. As a result of immunological abnormalities demonstrated, steroids are commonly used in Ménière's disease. The place of topical steroids is still controversial. In this investigation topical dexamethasone is applied for three months through a ventilation tube in patients with intractable vertigo. The results showed that this treatment controls vertigo in 72 per cent of cases. No patient was worse than before treatment. Only in 17 per cent of the patients was there an increase in hearing level. When compared to the reports which used only tympanostomy tubes, this procedure seems to have a placebo effect with minimal harmful effects. It appears that transtympanic dexamethasone application is a good alternative to vestibular nerve section. Topical treatment may be sufficient in most patients. Systemic treatment may be used in patients where topical treatment fails.

Keywords

Ménière's diseaseSteroidsTranstympanic dexamethasoneVertigo
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 113 , Issue 3 , March 1999 , pp. 217 - 221
Copyright
Copyright © JLO (1984) Limited 1999

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

Brookes, G. B. (1986) Circulating immune complexes in Ménière's disease. Archives of Otolaryngology – Head and Neck Surgery 112 536–540.CrossRefGoogle ScholarPubMed
Danckwardt-Lilliestrom, N., Friberg, U., Kinnetors, A. (1997) Endolymphatic sacitis in a case of active Ménière's disease. A TEM histopathological investigation. Annals of Otology, Rhinology and Laryngology 106(3) 190–198.CrossRefGoogle Scholar
Gutierrez, F., Moreno, P. M., Sainz, M. (1994) Relationship between immune complex and total hemolytic complement in endolymphatic hydrops. Laryngoscope 104 1495–1498.CrossRefGoogle ScholarPubMed
Itoh, A., Sakata, E. (1991) Treatment of vestibular disorders. Acta Otolaryngologica (Stockh) 481 617–623.CrossRefGoogle ScholarPubMed
Kimura, R. S., Hutta, J. (1997) Inhibition of experimentally induced endolymphatic hydrops by middle ear ventilation. European Archives of Otorhinolaryngology 254 213–218.CrossRefGoogle ScholarPubMed
Lohuis, P. J., ten Cate, W. J., Patterson, K. E. (1990) Modulation of rat stria vascularis in the absence of circulating adrenocorticosteroids. Acta Otolaryngologica (Stockh) 110 348–356.CrossRefGoogle ScholarPubMed
Montandon, P., Guillemin, P., Hausler, R. (1988) Prevention of vertigo in Ménière's syndrome by means of transtympanic ventilation tubes. ORL 50 377–381.CrossRefGoogle ScholarPubMed
Nadel, D. M. (1996) The use of systemic steroids in otolaryngology. Ear, Nose and Throat Journal 75 502–516.CrossRefGoogle ScholarPubMed
Pearson, B., Brackmann, D. E. (1985) Committee on hearing and equilibrium guidelines for reporting treatment results in Ménière's disease. Otolaryngology – Head and Neck Surgery 96 83–95.Google Scholar
Rarey, K. E., Lohuis, P. J. F. M., ten Cate, W. J. F. (1991) Response of stria vascularis to corticosteroids. Laryngoscope 101 1081–1084.CrossRefGoogle ScholarPubMed
Shea, J. J. (1993) Classification of Ménière's disease. American Journal of Otology 4 224–229.Google Scholar
Shea, J. J., Ge, X. (1996) Dexamethasone perfusion of the labyrinth plus intravenous dexamethasone for Ménière's disease. Otolaryngologic Clinics of North America 29 353–358.CrossRefGoogle ScholarPubMed
Silverstein, H., Choo, D., Rosenberg, S., Kuhn, J. (1996) Intratympanic steroid treatment of inner ear disease and tinnitus (Preliminary report). Ear, Nose and Throat Journal 75 468–488.CrossRefGoogle ScholarPubMed
Suzuki, M., Kitahara, M. (1992) Immunologic abnormality in Ménière's disease. Otolaryngology – Head and Neck Surgery 107 57–62.CrossRefGoogle ScholarPubMed
Tumarkin, A. (1966) Thoughts on the treatment of labyrinthopathy. Journal of Laryngology and Otology 80 1041–1053.CrossRefGoogle ScholarPubMed
Yamanobe, S., Harris, J. P. (1993) Inner ear specific antibodies. Laryngoscope 103 319–325.CrossRefGoogle Scholar
Yoo, T. J. (1984) Etiopathogenesis of Ménière's disease. A hypothesis. Annals of Otology, Rhinology and Laryngology (Suppl 113) 93 6–12.CrossRefGoogle Scholar