Intratympanic Dexamethasone as a Symptomatic Treatment for Ménière’s Disease

OBJECTIVEDetermine whether intratympanic (IT) dexamethasone, when given on an as needed basis, can successfully control Ménière’s disease (MD) symptoms in a large percentage of patients and allow them to avoid ablative therapies. STUDY DESIGNRetrospective chart review. SETTINGTertiary medical center. PATIENTSOne hundred fifty-nine patients met the American Academy of Otolaryngology–Head and Neck Surgery criteria for unilateral definitive MD. All patients failed dietary and medical therapy and received at least one IT dexamethasone treatment by one of 4 otologists in an academic center. INTERVENTION(S)IT dexamethasone. MAIN OUTCOME MEASURE(S)Patients were determined to be treatment failures if they did not achieve satisfactory control of their symptoms with IT dexamethasone and chose another treatment modality. Treatment success was defined as IT dexamethasone providing control of MD symptoms to the degree that they did not require any other further treatment modalities. RESULTSSuccessful avoidance of ablative surgery was achieved in 81.1% of patients with greater than 24 months of follow-up. No statistically significant associations were found related to age, sex, laterality, or duration of symptoms. For each IT dexamethasone perfusion sequence, there was a 20.0% increase in likelihood of successful treatment (OR, 1.20; 95% CI, 1.01–1.40; p = 0.01). CONCLUSIONIT dexamethasone is a successful adjuvant treatment for Ménière’s disease in patients on medial therapy and dietary restrictions.