Effectiveness of Intratympanic Dexamethasone in Otitis Media with Effusion Resistant to Conventional Therapy

Abstract

The aim of this study was to determine the efficiency of intratympanic dexamethasone (ITD) injections as a new treatment modality in otitis media with effusion resistant to conventional therapy. We planned a nonrandomized prospective study to determine the safety and effectiveness of the direct administration of dexamethasone into middle ear cavity with chronic eustachian tube dysfunction. This study was applied on 75 ears of 64 patients aged from 12 to 60years. ITD received 47 ears of 41 patients who had previously been treated by medical or surgical therapy middle ear effusion without resolution classified as study group. They were taken conventional medical therapy again 28 ears of 23 patients classified as a control group. ITDs were administered 0.5ml/4mg per mm directly in antero-superior quadrant of tympanic membrane. These injections were repeated once a week for 4weeks. Results were evaluated by using audiometric and tympanometric measurements 1 and 3months after the treatments. Audiometric measurement shows that 9.91dB improvement in the mean air-bone gap 15.17dB in air conduction (AC) pure-tone averages (PTA) and 5.25dB bone conduction (BC) PTA. But the control group data showed only 2dB improvement in the mean air-bone gap, 3dB AC-PTA and 1.36dB BC-PTA. Tympanometric improvement was found. In 28 ears of patients (59.6%) like type B or C converted to type A in study group without complication but only in three ears (10.7%) of control group. ITD administration to the middle ear is safe and effective for the treatment of otitis media with effusion or chronic eustachian tube dysfunction. No complications like tympanic membrane perforation and/or sensorineural hearing loss have occurred.