The use of electrocochleography to monitor the response of Ménière's disease patients to intratympanic steroids.

CONCLUSIONS

Intratympanic (IT) dexamethasone provides an alternative for patients with Ménière's disease (MD). A reduction of the endolymphatic hydrops is detected by the EcohG 1 month after the treatment.

OBJECTIVE

The use of intratympanic corticoid injections for MD has become popular due to the lack of reported adverse effects, but the mechanism of action is not well established. This study aimed to evaluate the changes in electrocochleography (EcohG) measurements during IT dexamethasone therapy.

METHODS

This study included 53 patients with unilateral MD refractory to medical therapy for at least 1 year. Each patient was treated with a fixed protocol of three consecutive weekly injections of a commercial 4 mg/ml dexamethasone preparation. EcohG measurements were performed 1 month before and 1 month after IT steroid therapy. The SP/AP ratio was measured before and after the IT treatment. A Kaplan-Meier analysis was used to evaluate the control of vertigo over a 2-year period.

RESULTS

Complete vertigo control (class A) was achieved in 22 patients (41.5%) at the 12-month follow-up and 8 patients (15.1%) at the 24-month follow-up. A significant reduction (p < 0.01) in the SP/AP ratio after the IT steroid treatment was observed.