Effect Of Intratympanic Dexamethasone Research Articles

Effect of intratympanic dexamethasone in idiopathic sudden sensorineural hearing loss concurrent with oral steroids

Effect of intratympanic dexamethasone in idiopathic sudden sensorineural hearing loss concurrent with oral steroids

Intratympanic (IT) Therapies for Menière's Disease: Some Consensus Among the Confusion.

Aminoglycosides and corticosteroids are commonly used to treat Menière's disease. Intratympanic (IT) administration of these medications allows high inner ear concentrations without significant adverse systemic effects. As a direct result, IT therapy has grown in popularity. Recent studies have compared patient outcomes between IT aminoglycosides and corticosteroids. This review summarizes these findings. Trials comparing IT corticosteroids to IT placebo or oral therapy have had conflicting results. Most recently, Lambert et al. investigated the effect of IT dexamethasone in a sustained-release formulation compared to placebo. Their findings demonstrated improvement in some secondary measures of vertigo with the sustained-release formulation.IT gentamicin is known to be effective in controlling vertigo in Menière's disease. In a recent study from 2016, Patel et al compared IT gentamicin and IT methylprednisolone in a double-blind, randomized controlled trial and identified no significant differences between the two in vertigo control. IT injections of aminoglycosides and corticosteroids can improve vertigo control. Hearing and vestibular loss however may result with IT aminoglycosides. Corticosteroids demonstrate limited hearing loss but may not have the same efficacy in controlling vertigo. Further investigation in the etiology of Menière's disease is needed to tailor the proposed treatment to suit the disease mechanism.

The effect of intra-tympanic dexamethasone on the vestibular function in patients with recurrent vertigo

Conclusion: The low clinical efficacy of the treatment for patients included in this work correlates with no noticeable effect on the vestibular function. Objective: To assess follow-up in patients with idiopathic and secondary Ménière’s disease after treatment with intra-tympanic dexamethasone and correlate clinical findings with changes in the vestibular-ocular reflex elicited after stimulation of each of the six semicircular canals. Methods: This is a single center retrospective review of patients presenting the clinical symptomatology of Meniérè’s disease treated with intra-tympanic dexamethasone. An audiometric evaluation was performed in each patient before and after treatment. The study cohort was divided into two groups: those evaluated after a short period of time and after a long period of time. Results: The study included 30 patients, mean age = 61 years. Differences in mean pure-tone average before and after treatment were non-significant for both treated (0.61 dB, p = 0.723) and untreated (0.59 dB, p = 0.609) ears. Vestibular–ocular reflex gain averages in the treated ear after treatment were 0.73 (superior semicircular canal), 0.86 (horizontal semicircular canal), and 0.69 (posterior semicircular canal). The gain did not vary significantly in the Superior (p = 0.194), the Horizontal (p = 0.646), or the Posterior Semicircular Canal (p = 0.820). Similar were obtained for the untreated ear.

The effect of intratympanic dexamethasone with oral prednisolone as a primary treatment in idiopathic sudden sensorineural hearing loss.

Sudden sensorineural hearing loss (SSNHL) is a true emergency that must be diagnosed and treated immediately. The purpose of this study is to compare the efficacy of treatment with intratympanic dexamethasone plus oral prednisolone daily or every other day with that of treatment with oral prednisolone alone. Sixty-three patients with SSNHL that had been present for less than 10 days prior to the start of treatment were randomly allocated to three different groups. Patients in group A were treated daily with oral prednisolone 1 mg/kg for 10 days plus intratympanic dexamethasone 2 mg for the first 3 days of treatment. Patients in group B were treated every other day with oral prednisolone 1 mg/kg for 10 days with the addition of intratympanic dexamethasone 2 mg for the first 3 treatments. Patients in group C were treated daily with oral prednisolone 1 mg/kg alone for 10 days. Audiometric parameters including pure tone audiometry (PTA), speech reception threshold (SRT), and speech discrimination score (SDS) were assessed on days 1,5, and 10. There was a significant improvement in PTA, SRT and SDS in each group over the 10 days but the greatest improvement was seen in the SRT measurements of group A in comparison with group B (19.81 ± 2.15, P=0.04) and C (26.26 ± 0.08, P=0.01). The difference in SRT between groups B and C was not statistically significant. The administration of intratympanic dexamethasone 2 mg daily for 3 days has an additive effect to that of 10 days of oral prednisolone 1 mg/kg in the treatment of SSNHL.

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

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.

Can Intratympanic Dexamethasone Protect against Cisplatin Ototoxicity in Mice with Age‐Related Hearing Loss?

To determine whether intratympanic (i.t.) dexamethasone ameliorates cisplatin-induced ototoxicity in a mouse model of presbycusis. Controlled experimental study. Translational science experimental laboratory. Auditory brainstem response (ABR) thresholds of 24-month-old CBA/J-NIA mice treated with cisplatin were compared 7 days after daily i.t. injections of dexamethasone (24 mg/mL) or saline. Because of high (100%) mortality at 16 mg/kg, a single cisplatin dose of 14 mg/kg intraperitoneally was used. At this latter dose, pre-i.t. and post-i.t. treatment ABR thresholds were available in 13 of 16 mice. In i.t. saline-treated ears, cisplatin produced up to 9.5-dB ABR threshold elevations. In i.t. dexamethasone-treated ears, little protection against cisplatin was observed at 8 or 16 kHz where mean ABR thresholds were elevated. At 24 and 32 kHz, mean ABR threshold elevations were minimal at 0.6 to 1.4 dB. This protection was statistically significant (P ≤ .02). These results demonstrate, for the first time, a protective effect of a treatment against an ototoxic agent in the presence of age-related hearing loss. In the presence of age-related hearing loss, the protective effect of i.t. dexamethasone has a frequency gradient, being greatest in the high-frequency region of the cochlea. This latter finding contrasts with our previous report in young mice, in which the protective effect of i.t. dexamethasone was in the low-frequency region of the cochlea.

Effect Of Intratympanic Dexamethasone on Noise-Induced Temporary Threshold Shift

To evaluate the effects of intratympanic treatment of dexamethasone (IT-DEX) and combination of DEX and hyaluronic acid (DEX/HA) for noise-induced temporary threshold shift (NITTS). NITTS was experimentally performed in 60 rats. Electrophysiologic hearing thresholds of the rats were measured before and right after noise exposure. Then, the rats were placed into two groups, the first 30 rats in an IT-DEX group and the second in an IT-DEX/HA group. Treatments were performed in the two subgroups (30 ears in one subgroup) of each group. In the IT-DEX group, one ear of each rat was treated with 0.02 mL IT-DEX, and the other ear was treated with IT 0.02 mL physiologic solution of serum saline. In the IT-DEX/HA group, one ear of each rat was treated with combination of 0.01 mL IT-DEX and 0.01 mL HA, and the other ear was treated with IT 0.02 mL of physiologic solution of serum saline. One week after the treatments, electrophysiologic hearing thresholds of all rats were measured again. No statistically significant difference was observed in recovery values of electrophysiologic hearing thresholds between IT-DEX and serum saline (P = .641) in the IT-DEX group. Also, we found no statistically significant difference in the recovery values of electrophysiologic hearing thresholds between IT-DEX/HA and serum saline (P = .344) in the IT-DEX/HA group. There is no effect of either IT-DEX and DEX/HA for NITTS.