Intratympanic Dexamethasone Injection Therapy for Meniere’s Disease Resistant to Conservative Treatment

Abstract

We adopted intratympanic dexamethasone injection therapy for 17 patients with Meniere’s disease who were resistant to conservative treatment for more than six months and continued to suffer from recurrent vertigo attacks. A 1-ml dose of dexamethasone injection solution (4.0 mg/ml) was administered intratympanically on a weekly basis at an outpatient clinic. The average monthly frequency of vertigo attacks during the six months prior to dexamethasone administration was compared with the average monthly frequency of vertigo attacks from 18 to 24 months after the treatment. Reduction in the frequency of vertigo attacks was observed in 15 out of the 17 cases. There was no significant change in hearing after the treatment as compared with before. Inner ear MRI with contrast was performed in 10 cases, and while cases with larger endolymphatic hydrops tended to have a poorer control of vertigo, no significant difference was observed. There were no cases of tympanic membrane perforation. Intratympanic dexamethasone injection therapy may be a potentially effective treatment for cases of refractory Meniere’s disease resistant to conservative therapy.