Duration of symptom control following intratympanic dexamethasone injections in Meniere’s disease

Hilton, A., McClelland, A., McCallum, R. and Kontorinis, G. (2022) Duration of symptom control following intratympanic dexamethasone injections in Meniere’s disease. European Archives of Oto-Rhino-Laryngology, 279(11), pp. 5191-5198. (doi: 10.1007/s00405-022-07368-w) (PMID:35397703) (PMCID:PMC9519661)

Abstract

Purpose: Intratympanic (IT) injections of corticosteroids have emerged as a non-ablative alternative to gentamicin in the management of refractory Meniere’s disease. However, currently, the duration of the symptom control achieved via intratympanic corticosteroids is under reported. Methods: We retrospectively reviewed the notes of all patients who underwent IT injections of dexamethasone for the treatment of definite Meniere’s disease at a single tertiary referral university centre over a 6-year period. We included demographic information, the number of procedures patients required, duration of symptom-control achieved (time interval between repeat IT injections), and the presence of co-morbidities, with a focus on the presence of autoimmune disease. Results: We identified 27 patients who underwent a total of 42 procedures; 23/27 (85.2%) patients demonstrated clinical response with a median period of symptom control of 14.5 months (range 1–64, IQR 10.25). The median longest asymptomatic period per patient was 19 months (range 11–64, IQR: 18). Interestingly, all patients with autoimmune disease (7/27) demonstrated a clinical response; autoimmune disease was found to be a statistically significant predictor of response to treatment (p = 0.002). In patients who received repeated treatment following disease relapse, there was no difference in duration of symptom-control achieved. Conclusions: IT steroids can provide an effective alternative to gentamicin ablation. Symptom control is achieved for a median of 14.5 months, and treatment can be repeated with no loss of efficacy. Those patients who have an underlying autoimmune co-morbidity are more likely to demonstrate a clinical response to therapy, which may provide insight into the underlying pathophysiology of Meniere’s disease.

• Item Type: Articles
• Status: Published
• Refereed: Yes
• Glasgow Author(s) Enlighten ID: Kontorinis, Mr Georgios
• Authors: Hilton, A., McClelland, A., McCallum, R., and Kontorinis, G.
• College/School: College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
• Journal Name: European Archives of Oto-Rhino-Laryngology
• Publisher: Springer
• ISSN: 0937-4477
• ISSN (Online): 1434-4726
• Published Online: 10 April 2022
• Copyright Holders: Copyright © 2022 The Authors
• First Published: First published in European Archives of Oto-Rhino-Laryngology 279(11): 5191-5198
• Publisher Policy: Reproduced under a Creative Commons License