A study of Intratympanic Dexamethasone Injection in Meniere's Disease (Continuation study)

Background: Meniere's disease is a condition that is thought to arise from abnormal fluid and ion homeostasis in the inner ear. The disease is named for Prospere Meniere, a French physician who was first known victim of this disease and reported that the inner ear could be the source of a syndrome manifesting episodic vertigo, tinnitus and hearing loss. The origin of Meniere's disease is presently controversial. While, in the past, it was felt that endolymphatic hydrops (excess fluid) in the inner ear were responsible for the disease, the most current opinion is that hydrops are just a marker for the Meniere's disease, rather than absolutely being responsible for the symptoms. Aim of the work:  this study aimed to follow up (2 and 2.5 years) the effect intratympanic (IT) dexamethasone in the prognosis of Meniere's disease (MD) with two different concentrations (4 and 10 mg/ml). Patients and methods: twenty patients with unilateral Meniere's disease received intra tympanic dexamethasone injection were included in this study .The studied subgroups  were categorized according to the concentration of dexamethasone (4 and 10 mg/ml) used into two subgroups. Detailed history was taken from all patients.  They were exposed to Dizziness Handicap Inventory scale, basic audiological evaluation and cervical-vestibular evoked myogenic potential assessment. The presence or absence of spontaneous, post-head-shaking, and positional nystagmus was evaluated using a video-nystagmography system. The patients in the two groups were followed -up for 2 and 2.5 years. Results:  the dosage of 10mg/ml dexamethasone showed more stability in signs and symptoms of Meniere's disease than the dose of 4 mg/ml dexamethasone in follow up study.  The long term study of intratympanic (IT) dexamethasone injection in both subgroups shows nearly no improvement as regard pure tone average, speech reception thresholds, word discrimination scores, subjective hearing loss, tinnitus, aural fullness, vertigo interruption with daily activities and vertigo associated symptoms compared to the previous study thesis. Conclusion: the long-term study of intratympanic (IT) Dexamethasone injection in both subgroups showed nearly no improvement in most assessments performed.