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Intratympanic steroid therapy for inner ear diseases, a review of the literature

  • Otology
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European Archives of Oto-Rhino-Laryngology and Head & Neck Aims and scope Submit manuscript

Abstract

To evaluate the value of clinical trials on intratympanic steroid therapy in Ménière’s disease (MD), idiopathic sudden sensorineural hearing loss (ISSNHL) and rapidly progressive sensorineural hearing loss (RPSNHL). Medline and Pubmed databases from 1966 to present were searched for clinical studies on intra- or transtympanic (cortico)steroid therapy of MD, ISSNHL and RPSNHL. Results were cross-checked with additional databases to obtain a complete data set. Clinical trials were evaluated on the basis of comparability, internal and external validity. Articles were judged using the following questions: was a randomised double-blind controlled trial performed? Which criteria were used to confirm the diagnosis of MD, ISSNHL, RPSNHL? Which therapy was evaluated? How long was the follow-up? Which criteria were used to evaluate the results? Reliable evidence on the efficiency, optimum dosage and administration schedule of intratympanic steroid therapy in MD, ISSNHL and RPSNHL is lacking, therefore further investigation is required.

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References

  1. Ryan AF, Harris JP, Keithley EM (2002) Immune-mediated hearing loss: basic mechanisms and options for therapy. Acta Otolaryngol (Stockh) 548(Suppl):38–43

    Article  Google Scholar 

  2. Derebery MJ (1996) Allergic and immunologic aspects of Ménière’s disease. Otolaryngol Head Neck Surg 114(3):360–365

    Article  PubMed  CAS  Google Scholar 

  3. Yoo TJ, Kwon SS (2002) Molecular mechanism of autoimmune hearing loss. Acta Otolaryngol (Stockh) 548(Suppl):3–9

    Article  Google Scholar 

  4. Fuse T, Hayashi T, Oota N et al (2003) Immunological responses in acute low-tone sensorineural hearing loss and Ménière’s disease. Acta Otolaryngol (Stockh) 123:26–31

    Article  Google Scholar 

  5. McCabe BF (1979) Autoimmune sensorineural hearing loss. Ann Otol Rhinol Laryngol 88:585–589

    PubMed  CAS  Google Scholar 

  6. Moskowitz D, Lee KJ, Smith HW (1984) Steroid use in sudden sensorineural hearing loss. Laryngoscope 94:664–666

    Article  PubMed  CAS  Google Scholar 

  7. Silverstein H, Choo D, Rosenberg S, Kuhn J, Seidman MD, Stein I (1996) Intratympanic steroid treatment of inner ear disease and tinnitus (preliminary report). Ear Nose Throat J 75(8):468–471

    PubMed  CAS  Google Scholar 

  8. Shirwany NA, Seidman MD, Tang W (1998) Effect of transtympanic injection of steroids on cochlear blood flow, auditory sensitivity, and histology in the guinea pig. Am J Otol 19(2):230–235

    PubMed  CAS  Google Scholar 

  9. Fukushima M, Kitahara T, Uno Y, Fuse Y, Doi K, Kubo T (2002) Effects of intratympanic injection of steroids on changes in rat inner ear aquaporin expression. Acta Otolaryngol (Stockh) 122:600–606

    Article  CAS  Google Scholar 

  10. Chandrasekhar S, Rubinstein R, Kwartler J et al (2000) Dexamethasone pharmacokinetics in the inner ear: comparison of route of administration and use of facilitating agents. Otolaryngol Head Neck Surg 122(4):521–528

    Article  PubMed  CAS  Google Scholar 

  11. Parnes LS, Sun AH, Freeman DJ (1999) Corticosteroid Pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope 109(Suppl 91):1–17

    Article  PubMed  CAS  Google Scholar 

  12. Jackson LE, Silverstein H (2002) Chemical perfusion of the inner ear. Otolaryngol Clin North Am 35:639–653

    Article  PubMed  Google Scholar 

  13. Committee on Hearing and Equilibrium AAO-HNS (1995) Committee on hearing and equilibrium guidelines for the diagnosis and the evaluation of therapy in Ménière’s disease. Otolaryngol Head Neck Surg 113(3):181–185

    Google Scholar 

  14. Stokroos RJ, Albers F (1996) The etiology of idiopathic sudden sensorineural hearing loss. A review of the literature. Acta Oto-rhino-laryngol Belg 50:69–76

    CAS  Google Scholar 

  15. Moscicki R, San Martin J, Quintera C (1994) Serum antibody to inner ear proteins in patients with progressive hearing loss. Correlation with disease activity and reponse to corticosteroid treatment. JAMA 272(8):611–616

    Article  PubMed  CAS  Google Scholar 

  16. Silverstein H, Isaacson J, Olds M, Rowan P, Rosenberg S (1998) Dexamethasone inner ear perfusion for the treatment of Ménière’s disease: a prospective, randomized, double-blind, crossover trial. Am J Otol 19(2):196–201

    PubMed  CAS  Google Scholar 

  17. Sennaroglu L, Sennaroglu G, Gursel B, Dini FM (2001) Intratympanic dexamethasone, intratympanic gentamicin, and endolymphatic sac surgery for intractable vertigo in Ménière’s disease. Otolaryngol Head Neck Surg 125(5):537–43

    PubMed  CAS  Google Scholar 

  18. Itoh A, Sakata E (1991) Treatment of vestibular disorders. Acta Otolaryngol (Stockh) Suppl 481:617–623

    Article  CAS  Google Scholar 

  19. sShea JJ (1997) The role of dexamethasone or streptomycin perfusion in the treatment of Meniere’s disease. Otolaryngol Clin North Am 30(6):1051–1059

    PubMed  Google Scholar 

  20. Hirvonen T, Peltomaa M, Ylikoski J (2000) Intratympanic and systemic dexamethasone for Ménière’s disease. ORL J Otorhinolaryngol Relat Spec 62(3):117–120

    PubMed  CAS  Google Scholar 

  21. Barrs D, Keyser J, Stallworth C, McElveen JJ (2001) Intratympanic steroid injections for intractable Ménière’s disease. Laryngoscope 111(12):2100–2104

    Article  PubMed  CAS  Google Scholar 

  22. Chandrasekhar S (2001) Intratympanic dexamethasone for sudden sensorineural hearing loss: clinical and laboratory evaluation. Otol Neurotol 22(1):18–23

    Article  PubMed  CAS  Google Scholar 

  23. Shea JJJ, Xianxi G (1996) Dexamethasone perfusion of the labyrinth plus intravenous dexamethasone for meniere’s disease. Otolaryngol Clin North Am 29(2):353–358

    PubMed  Google Scholar 

  24. Gianoli GJ, Li JC (2001) Transtympanic steroids for treatment of sudden hearing loss. Otolaryngol Head Neck Surg 125(3):142–146

    Article  PubMed  CAS  Google Scholar 

  25. Sennaroglu L, Dini FM, Sennaroglu G, Gursel B, Ozkan S (1999) Transtympanic dexamethasone application in Ménière’s disease: an alternative treatment for intractable vertigo. J Larngol Otol 113:217–21

    CAS  Google Scholar 

  26. Arriaga M, Goldman S (1998) Hearing results of intratympanic steroid treatment of endolymphatic hydrops. Laryngoscope 108(11 Pt 1):1682–1685

    Article  PubMed  CAS  Google Scholar 

  27. Alzamil KS, Linthicum FHJ (2000) Extraneous round window membranes and plugs: possible effect on intratympanic therapy. Ann Otol Rhinol Laryngol 109(1):30–32

    PubMed  CAS  Google Scholar 

  28. Plontke S, Zenner HP (2002) Pharmacokinetic considerations in intratympanic drug delivery to the inner ear. Acta Oto-rhino-laryngol Belg 56:369–370

    CAS  Google Scholar 

  29. Shea JJ Jr, Ge X (1996) Dexamethasone perfusion of the labyrinth plus intravenous dexamethasone for Ménière’s disease. Otolaryngol Clin North Am 29(2):353–358

    PubMed  Google Scholar 

  30. Shea JJ Jr (1993) Classification of Ménière’s disease. Am J Otol 14:224–229

    PubMed  Google Scholar 

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Maastricht, P. Debyelaan 25, P.O. Box 5800, 6202 AZ, Maastricht, The Netherlands

    M. J. R. C Alles, M. A. der Gaag & R. J. Stokroos

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  1. M. J. R. C Alles
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  2. M. A. der Gaag
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  3. R. J. Stokroos
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Correspondence to R. J. Stokroos.

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Alles, M.J.R.C., der Gaag, M.A. & Stokroos, R.J. Intratympanic steroid therapy for inner ear diseases, a review of the literature. Eur Arch Otorhinolaryngol 263, 791–797 (2006). https://doi.org/10.1007/s00405-006-0065-3

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  • DOI: https://doi.org/10.1007/s00405-006-0065-3

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