Abstract
Meniere's disease is a common inner ear disease with an incidence of 15-50 per 100, 000 population. Since Meniere's disease is thought to be triggered by an immune insult to inner ear, we examined intra-endolymphatic sac application of large doses of steroids as de novo treatment for intractable Meniere's disease.
METHODS
Between 1996 and 2005, we enrolled and assigned 197 intractable Meniere's patients to three groups: Group-I (G-I)-patients who underwent endolymphatic sac drainage and steroid-instillation, Group-II (G-II)-those who underwent endolymphatic sac drainage without steroid-instillation and Group-III (G-III)-those who declined endolymphatic sac drainage. Definitive spells and hearing in all three groups were determined for 2-7 years after treatment.
RESULTS
According to the criteria in 1995 AAO-HNS, two-year results demonstrated that vertigo was completely controlled in 88.0% of patients in G-I (n=100), 85.1% in G-II (n=47) and 8.0% in G-III (n=50)(statistically G-I=GII>G-III). Hearing was improved in 49.0% of patients in G-I, 31.9% in G-II and 6.0% in G-III (statistically GI>G-II>G-III). Results after seven years showed that vertigo was completely controlled in 78.8% of patients in G-I, 79.2% in G-II and 25.0% in G-III (statistically G-I=G-II>G-III). Hearing improved in 36.5% of patients in GI, 8.3% in G-II and 0.0% in G-III (statistically G-I>G-II=G-III).
DISCUSSION
From non-surgical observation in G-III for at least 7 years after treatment, large doses of steroids instilled into endolymphatic sac in G-I significantly improved hearing in intractable Meniere's patients, more so than endolymphatic sac drainage without steroids in G-II.
