Intratympanic steroid injections for intractable Meniere's disease
Intratympanic steroid injections for intractable Meniere's disease
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DOI：
10.1097/00005537-200112000-00003
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发表时间：
2001-12-01
期刊：
影响因子：
2.6
通讯作者：
McElveen, JT
中科院分区：
文献类型：
--
作者：
Barrs, DM;Keyser, JS;McElveen, JT
目的：检查鼓室内注射地塞米松是否能有效控制梅尼埃病患者的眩晕，这些患者尽管接受了标准药物治疗，包括低盐/无咖啡因饮食和利尿剂，但仍有持续性眩晕。研究设计：前瞻性研究。研究方法：从1999年8月至2000年11月，21例难治性梅尼埃病患者在4周内接受了4 mg/mL地塞米松鼓室内注射作为办公室程序。使用美国耳鼻咽喉头颈外科学会指南定义和报告梅尼埃病的结果。(1)结果：21例患者中有11例（52%）在3个月和9例（43%）在6个月时眩晕完全缓解。在5名最初控制眩晕但后来失败的患者中重复注射，在3名（60%）患者中获得控制。并发症发生率低：一名患者在治疗期间听力平均下降35分贝，一名患者持续鼓膜穿孔。结论.鼓室内注射地塞米松是治疗梅尼埃病持续性眩晕的合理初始手术治疗方法。主要的好处是避免了类固醇的全身给药，成本低于内淋巴囊手术，并易于管理作为一个办公室程序。缺点是需要重复的办公室访问注射和有效性随着时间的推移而下降。
Objective: To examine whether intratympanic injection of dexamethasone is effective in controlling vertigo in patients with Meniere's disease who have persistent vertigo despite standard medical treatment, including a low-salt/no-caffeine diet and diuretics. Study Design: A prospective study. Methods: From August 1999 to November 2000, 21 patients with intractable Meniere's disease underwent intratympanic injections of 4 mg/mL dexamethasone over a period of 4 weeks as an office procedure. American Academy of Otolaryngology-Head and Neck Surgery guidelines for the definition and reporting of results in Meniere's disease were used.(1) Results: Complete relief of vertigo was maintained in 11 of the 21 patients (52%) at 3 months and in 9 of 21 patients (43%) at 6 months. Repeat injections in 5 patients who had initial control of vertigo, but later failed, yielded control in 3 (60%) patients. The complication rate was low: one patient had a 35-decibel pure tone average decrease in hearing during treatment and one patient had a persistent tympanic membrane perforation. Conclusions. Intratympanic injections of dexamethasone are a reasonable initial surgical treatment for persistent vertigo in Meniere's disease. The principal benefits are avoidance of systemic administration of steroids, lower cost than endolymphatic sac surgery, and ease of administration as an office procedure. The disadvantages are the need for repeated office visits for injections and the decreasing effectiveness over time.