Pradhan Pradeep, Lal Priti, Sen Kanwar
1Department of Otorhinolaryngology, All India Institute of Medical Sciences, Bhubaneswar, Odisha 751019 India.
4Department of ENT and Head Neck Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha 751019 India.
Indian J Otolaryngol Head Neck Surg. 2019 Nov;71(Suppl 2):1369-1373. doi: 10.1007/s12070-018-1431-3. Epub 2018 Jun 24.
To evaluate the long term effect of Intratympanic dexamethasone in intractable Meniere's disease. 30 patients with refractory Meniere's disease which did not respond to the standard medical management, were treated with Intratympanic dexamethasone injections. Post treatment hearing outcome and dizziness scores were compared with the pretreatment values respectively. The mean dizziness handicap inventory (DHI) score was reduced from 91.58 (range 80-100) to be 31.00 ( = 0.00) at 3 months of treatment. With the successive follow-up periods, the mean DHI scores were reduced to 51.50, 46.6, and 50.90 at the end of, 6, 12, and 24 months ( = 0.04, 0.35, and 0.49 respectively). Again at the end of 24 months, 23.80% of patients were free of vertigo (= 0.01). No patient had improvement in the hearing (> 10 dB) in any of the follow-up periods and 6.6% demonstrated deterioration in hearing. There were no major intraoperative or postoperative complications detected. Intratympanic injection of steroid is a safe and effective method for treating intractable Meniere's disease. Although short term improvement in the vertigo is well documented, still in 23% of the patients were found to be free of vertigo at even the end of 24 months. There was no significant improvement in hearing noticed, either in short term or in long term.
为评估鼓室内注射地塞米松治疗难治性梅尼埃病的长期疗效。选取30例对标准药物治疗无反应的难治性梅尼埃病患者,采用鼓室内注射地塞米松治疗。分别将治疗后的听力结果和头晕评分与治疗前的值进行比较。治疗3个月时,平均头晕残障量表(DHI)评分从91.58(范围80 - 100)降至31.00(P = 0.00)。随着后续随访期的进行,在6、12和24个月结束时,平均DHI评分分别降至51.50、46.6和50.90(P分别为0.04、0.35和0.49)。在24个月结束时,再次有23.80%的患者无眩晕发作(P = 0.01)。在任何随访期内,均无患者听力改善超过10dB,且6.6%的患者听力出现恶化。未检测到重大的术中或术后并发症。鼓室内注射类固醇是治疗难治性梅尼埃病的一种安全有效的方法。虽然眩晕的短期改善已有充分记录,但即使在24个月结束时仍有23%的患者无眩晕发作。无论短期还是长期,均未发现听力有显著改善。