Intratympaniccorticosteroids on hearing and vertigo forménière’s disease: A review of the literature
Main Article Content
Abstract
Toevaluate the value of intratympanic steroid therapy on hearing and vertigo in Meniere’s disease, a search of electronic databases Pubmed, Web of Science, Cochrane library and Google scholar was performed using keyword transtympanic corticosteroid and meniere. Of the 471 studies identified, 16 eligible publications were included in the full-text analysis. We found16 articles matching the selection criteria related to 1474 patients with 2 different tympanic cavity injection drugs including: Dexamethasone, Methylprednisolone. We have conducted an analysis of the characteristics and therapeutic effectiveness of the above drugs. Although the effectiveness is still debated, transtympanic Corticosteroid injection is relatively safe and effective in controlling vertigo although it gradually decreases over time. No significant improvement in hearing ability was observed.
Article Details
Keywords
Ménière Disease (MD), Endolymphatic hydrops (DEH), Intratympanic Steroid (ITS),Intratympanic Glucocorticoid
References
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2. Basura, G. J. et al. Clinical Practice Guideline: Ménière’s Disease. Otolaryngol Head Neck Surg. 2020;162: S1–S55 .
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7. Beyea J.A, Instrum R.S, Agrawal S.K, Parnes L.S. Intratympanic Dexamethasone in the Treatment of Meniere’s Disease: A Comparison of Two Techniques. Otology & Neurotology. 2017; 38(6): e173-e178.
8. Garduno-Anaya M.A, De Toledo H.C, Hinojosa-Gonzalez R. et al. Dexamethasone Inner Ear Perfusion by Intratympanic Injection in Unilateral Meniere’s Disease: A Two-year Prospective, Placebo-Controlled, Double-blind, Randomized Trial. Otolaryngology-Head and Neck Surgery. 2005; 133:285-294.
9. Al Attrache N.A, Krstulovic C, Guillen V.P. et al. Response Over Time of Vertigo Spells to Intratympanic Dexamethasone Treatment in Meniere’s Disease Patients. The Journal of International Advanced Otology. 2016; 12(1):92-7.
10. Ozturk K and Ata N. Intratympanic mixture gentamicin and dexamethasone versus dexamethasone for unilateral Meniere’s disease. American Journal of Otolaryngology. 2019; 40: 711-714.
11. Phillips J, Mikulec A.A, Robinson J.M. et al. Efficacy of Intratympanic OTO-104 for the Treament of Meniere’s Disease: The Outcome of Three Randomized, Double-Blind, Placebo-Controlled Studies. Otology & Neurotology. 2023; 44(6): 584-592.
12. Lambert P.R, Nguyen S, Maxwell K.S. et al. A Randomized, Double-Blind, Placebo-Controlled Clinical Study to Assess Safety and Clinical Activity of OTO-104 Given as a Single Intratympanic Injection in Patients With Unilateral Meniere’s Disease. Otology & Neurotology. 2012; 33: 1257-1265.
13. Lampert P.R, Carey J, Mikulec A.A. et al. Intratympanic Sustained-Exposure Dexamethasone Thermosensitive Gel for Symptoms of Meniere’s Disease: Randomized Phase 2b Safety and Efficacy Trial. Otology & Neurotology. 2016; 37: 1669-1676.
14. Albu S, Chirtes F, Trombitas V. et al. Intratympanic Dexamethasone versus High Dosage of Betahistine in the Treatment of Intractable Unilateral Meniere Disease. American Journal of Otolaryngology. 2015; 36(2): 205-9.
15. Albu S, Nagy A, Doros C. et al. Treatment of Meniere’s Disease with Intratympanic Dexamethasone plus High Dosage of Betahistine. American Journal of Otolaryngology. 2016; 37(3): 225-30.
16. Casani A.P, Piaggi P, Cerchiai N. et al. Intratympanic Treatment of Intractable Unilateral Meniere’s Disease: Gentamicin or Dexamethasone? A Randomized Controlled Trial. Otolaryngology - Head and Neck Surgery. 2012; 146(3): 430-7.
17. Sennaroglu L, Sennaroglu G, Gursel B. et al. Intratympanic dexamethasone, intratympanic gentamycin, and endolymphatic sac surgery for intractable vertigo in Meniere’s Disease. Otolaryngology - Head and Neck Surgery. 2001; 125(5):537-43.
18. Naples J.G, Henry L, Brant J.A. et al. Intratympanic Therapies in Meniere Disease: Evaluation of Outcomes and Early Vertigo Control. The Laryngoscope. 2019; 129(1): 216-221.
19. Patel M, Agarwal K, Arshad Q. et al. Intratympanic methylprednisolone versus gentamicin in patients with unilateral Meniere’s Disease: a randomised, double-blind, comparative effectiveness trial. Lancet. 2016; 388(10061): 2753-2762.
20. Gabra N and Saliba I. The Effect of Intratympanic Methylprednisolone and Gentamicin Injection on Meniere’s Disease. Otolaryngology-Head and Neck Surgery. 2013; 148(4): 642-7.
21. Harcourt J.P, Lambert A, Wong P.Y. et al. Long-Term Follow-Up of Intratympanic Methylprednisolone Versus Gentamicin in Patients With Unilateral Meniere’s Disease. Otology & Neurotology. 2019; 40(4):491-496.
22. Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menière’s disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc. Otolaryngol Head Neck Surg. 1995; 113:181–185.
23. Belinchon A, Perez-Garrigues H, Tenias JM. Evolution of symptoms in Ménière’s disease. Audiol Neurootol. 2012; 17: 126-32.
24. Crane, B. T., Minor, L. B., Della Santina, C. C. & Carey, J. P. Middle ear exploration in patients with Ménière’s disease who have failed outpatient intratympanic gentamicin therapy. Otol Neurotol. 2009;30: 619–624.
25. Parnes, L. S., Sun, A. H. & Freeman, D. J. Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope. 1999;109: 1–17.
26. Belhassen, S. & Saliba, I. Pain assessment of the intratympanic injections: a prospective comparative study. Eur Arch Otorhinolaryngol. 2012; 269: 2467–2473.
2. Basura, G. J. et al. Clinical Practice Guideline: Ménière’s Disease. Otolaryngol Head Neck Surg. 2020;162: S1–S55 .
3. Ghavami Y, Haidar Y.M, Moshtaghi O, Lin H.W, Djalilian H.R. Evaluating Quality of Life in Patients With Meniere’s Disease Treated as Migraine. Annals of Otology. Rhinology & Laryngology. 2018; 127(12): 877-887.
4. Webster K.E. et al. Systemic pharmacological interventions for Meniere’s disease. Cochrane Database of Systematic Reviews. 2023; 2(2): CD015171.
5. Webster K.E. et al Intratympanic corticosteroids for Meniere’s disease. Cochrane Database of Systematic Reviews. 2023; 2(2): CD015245.
6. Martin Sanz E, Christiane Z.L, Manuel G.J. et al. Control of Vertigo After Intratympanic Corticoid Therapy for Unilateral Meniere’s Disease: A Comparison of Weekly Versus Daily Fixed Protocol. Otology & Neurotology. 2013; 34: 1429-1433.
7. Beyea J.A, Instrum R.S, Agrawal S.K, Parnes L.S. Intratympanic Dexamethasone in the Treatment of Meniere’s Disease: A Comparison of Two Techniques. Otology & Neurotology. 2017; 38(6): e173-e178.
8. Garduno-Anaya M.A, De Toledo H.C, Hinojosa-Gonzalez R. et al. Dexamethasone Inner Ear Perfusion by Intratympanic Injection in Unilateral Meniere’s Disease: A Two-year Prospective, Placebo-Controlled, Double-blind, Randomized Trial. Otolaryngology-Head and Neck Surgery. 2005; 133:285-294.
9. Al Attrache N.A, Krstulovic C, Guillen V.P. et al. Response Over Time of Vertigo Spells to Intratympanic Dexamethasone Treatment in Meniere’s Disease Patients. The Journal of International Advanced Otology. 2016; 12(1):92-7.
10. Ozturk K and Ata N. Intratympanic mixture gentamicin and dexamethasone versus dexamethasone for unilateral Meniere’s disease. American Journal of Otolaryngology. 2019; 40: 711-714.
11. Phillips J, Mikulec A.A, Robinson J.M. et al. Efficacy of Intratympanic OTO-104 for the Treament of Meniere’s Disease: The Outcome of Three Randomized, Double-Blind, Placebo-Controlled Studies. Otology & Neurotology. 2023; 44(6): 584-592.
12. Lambert P.R, Nguyen S, Maxwell K.S. et al. A Randomized, Double-Blind, Placebo-Controlled Clinical Study to Assess Safety and Clinical Activity of OTO-104 Given as a Single Intratympanic Injection in Patients With Unilateral Meniere’s Disease. Otology & Neurotology. 2012; 33: 1257-1265.
13. Lampert P.R, Carey J, Mikulec A.A. et al. Intratympanic Sustained-Exposure Dexamethasone Thermosensitive Gel for Symptoms of Meniere’s Disease: Randomized Phase 2b Safety and Efficacy Trial. Otology & Neurotology. 2016; 37: 1669-1676.
14. Albu S, Chirtes F, Trombitas V. et al. Intratympanic Dexamethasone versus High Dosage of Betahistine in the Treatment of Intractable Unilateral Meniere Disease. American Journal of Otolaryngology. 2015; 36(2): 205-9.
15. Albu S, Nagy A, Doros C. et al. Treatment of Meniere’s Disease with Intratympanic Dexamethasone plus High Dosage of Betahistine. American Journal of Otolaryngology. 2016; 37(3): 225-30.
16. Casani A.P, Piaggi P, Cerchiai N. et al. Intratympanic Treatment of Intractable Unilateral Meniere’s Disease: Gentamicin or Dexamethasone? A Randomized Controlled Trial. Otolaryngology - Head and Neck Surgery. 2012; 146(3): 430-7.
17. Sennaroglu L, Sennaroglu G, Gursel B. et al. Intratympanic dexamethasone, intratympanic gentamycin, and endolymphatic sac surgery for intractable vertigo in Meniere’s Disease. Otolaryngology - Head and Neck Surgery. 2001; 125(5):537-43.
18. Naples J.G, Henry L, Brant J.A. et al. Intratympanic Therapies in Meniere Disease: Evaluation of Outcomes and Early Vertigo Control. The Laryngoscope. 2019; 129(1): 216-221.
19. Patel M, Agarwal K, Arshad Q. et al. Intratympanic methylprednisolone versus gentamicin in patients with unilateral Meniere’s Disease: a randomised, double-blind, comparative effectiveness trial. Lancet. 2016; 388(10061): 2753-2762.
20. Gabra N and Saliba I. The Effect of Intratympanic Methylprednisolone and Gentamicin Injection on Meniere’s Disease. Otolaryngology-Head and Neck Surgery. 2013; 148(4): 642-7.
21. Harcourt J.P, Lambert A, Wong P.Y. et al. Long-Term Follow-Up of Intratympanic Methylprednisolone Versus Gentamicin in Patients With Unilateral Meniere’s Disease. Otology & Neurotology. 2019; 40(4):491-496.
22. Committee on Hearing and Equilibrium guidelines for the diagnosis and evaluation of therapy in Menière’s disease. American Academy of Otolaryngology-Head and Neck Foundation, Inc. Otolaryngol Head Neck Surg. 1995; 113:181–185.
23. Belinchon A, Perez-Garrigues H, Tenias JM. Evolution of symptoms in Ménière’s disease. Audiol Neurootol. 2012; 17: 126-32.
24. Crane, B. T., Minor, L. B., Della Santina, C. C. & Carey, J. P. Middle ear exploration in patients with Ménière’s disease who have failed outpatient intratympanic gentamicin therapy. Otol Neurotol. 2009;30: 619–624.
25. Parnes, L. S., Sun, A. H. & Freeman, D. J. Corticosteroid pharmacokinetics in the inner ear fluids: an animal study followed by clinical application. Laryngoscope. 1999;109: 1–17.
26. Belhassen, S. & Saliba, I. Pain assessment of the intratympanic injections: a prospective comparative study. Eur Arch Otorhinolaryngol. 2012; 269: 2467–2473.