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Intratympanic (IT) Therapies for Menière’s Disease: Some Consensus Among the Confusion

  • Otology: Vestibular Disorders (J Rutka, Section Editor)
  • Published:
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Abstract

Purpose of Review

Aminoglycosides and corticosteroids are commonly used to treat Menière’s disease. Intratympanic (IT) administration of these medications allows high inner ear concentrations without significant adverse systemic effects. As a direct result, IT therapy has grown in popularity. Recent studies have compared patient outcomes between IT aminoglycosides and corticosteroids. This review summarizes these findings.

Recent Findings

Trials comparing IT corticosteroids to IT placebo or oral therapy have had conflicting results. Most recently, Lambert et al. investigated the effect of IT dexamethasone in a sustained-release formulation compared to placebo. Their findings demonstrated improvement in some secondary measures of vertigo with the sustained-release formulation. IT gentamicin is known to be effective in controlling vertigo in Menière’s disease. In a recent study from 2016, Patel et al. compared IT gentamicin and IT methylprednisolone in a double-blind, randomized controlled trial and identified no significant differences between the two in vertigo control.

Summary

IT injections of aminoglycosides and corticosteroids can improve vertigo control. Hearing and vestibular loss however may result with IT aminoglycosides. Corticosteroids demonstrate limited hearing loss but may not have the same efficacy in controlling vertigo. Further investigation in the etiology of Menière’s disease is needed to tailor the proposed treatment to suit the disease mechanism.

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Acknowledgements

This work was supported in part by NIH NIDCD grant T32DC000027. The authors would like to thank the Johns Hopkins Center for Hearing and Balance for their continued support.

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  1. Department of Otolaryngology-Head and Neck Surgery, Johns Hopkins University School of Medicine, 601 N. Caroline Street, Baltimore, MD, 21287, USA

    Desi P. Schoo, Grace X. Tan, Matthew R. Ehrenburg, Seth E. Pross, Bryan K. Ward & John P. Carey

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  1. Desi P. Schoo
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Correspondence to Desi P. Schoo.

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Dr. Desi P Schoo, Dr. Grace X Tan, Matthew R Ehrenburg, Dr. Seth E Pross, and Dr. Bryan K Ward declare that they have no conflicts of interest. Dr. John P Carey declares that he is a site investigator for a clinical trial of OTO-104 in Menière’s disease.

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Desi P. Schoo and Grace X. Tan are dual first authors.

This article is part of the Topical Collection on Otology: Vestibular Disorders

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Schoo, D.P., Tan, G.X., Ehrenburg, M.R. et al. Intratympanic (IT) Therapies for Menière’s Disease: Some Consensus Among the Confusion. Curr Otorhinolaryngol Rep 5, 132–141 (2017). https://doi.org/10.1007/s40136-017-0153-5

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