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ORIGINAL ARTICLE
Year : 2015  |  Volume : 31  |  Issue : 2  |  Page : 128-134

Intratympanic dexamethasone injection in Meniere's disease


1 Audiology Unit, Department of ORL, Faculty of Medicine, Ain Shams University, Cairo, Egypt
2 Audiology Unit, Military Medical Academy, Cairo, Egypt

Correspondence Address:
Dalia Mohamed Hassan
Audiology Unit, Department of ORL, Faculty of Medicine, Ain Shams University, Cairo, P.O. Box 1156
Egypt
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1012-5574.156098

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Aim The aim of the study was to investigate the role of intratympanic (IT) dexamethasone in the treatment of medically refractory Meniere's disease (MD) using two different concentrations. Patients and methods Twenty-four adults with unilateral MD received a single IT injection of dexamethasone at 4 or 10 mg/ml concentration. Partial or no improvement over the next 1 month following injection necessitated a second injection. Before and after injection, all patients underwent detailed history taking, were evaluated with the Dizziness Handicap Inventory scale, and underwent basic audiological evaluation and assessment of cervical-vestibular evoked myogenic potential. The presence or absence of spontaneous, post-head-shaking, and positional nystagmus was assessed using a video-nystagmography system. Twelve patients served as the control group and were followed up subjectively for 1 month. Results Both 4 and 10 mg/ml IT dexamethasone improved all subjective symptoms and pure-tone audiometry thresholds. The cervical-vestibular evoked myogenic potential asymmetry ratio dropped after injection. However, the 10 mg/ml concentration was superior to the 5 mg/ml concentration in improving the signs of disease activity, Dizziness Handicap Inventory scores, and the duration of vertigo attacks. No change was reported by the controls. Conclusion IT dexamethasone injection might be helpful in controlling MD in some patients. The 10 mg/ml dexamethasone concentration controls vertigo at both the subjective and objective level. Especially if used early in the course of the disease


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