Intratympanic injection in delayed endolymphatic hydrops

Acta Otolaryngol. 2015;135(10):1016-21. doi: 10.3109/00016489.2015.1052984. Epub 2015 Jun 8.

Abstract

Conclusions: The present study showed that intratympanic dexamethasone injection (ITD) is a promising approach for the treatment of contralateral and ipsilateral delayed endolymphatic hydrops (DEH). Moreover, intratympanic gentamicin injection (ITG), as a chemical labyrinthectomy, is a simple alternative for controlling vertigo in patients with ipsilateral DEH.

Objective: This study examined the effect of ITD or ITG on DEH.

Methods: Fourteen patients with DEH completed the clinical and audio-vestibular evaluation. Among them, 10 cases (ipsilateral type: nine cases, contralateral type: one case) were treated with intratympanic injection. Four patients with ipsilateral DEH underwent ITG, five patients with ipsilateral type and one patient with contralateral type received ITD. All 10 cases were followed up for 8-48 months.

Results: Complete and substantial vertigo control was achieved in four of nine ipsilateral DEH patients treated with ITG. In the other five ipsilateral cases who received ITD, two accomplished complete vertigo control and two had substantial control. In one case, the vertigo was not effectively controlled. One case of contralateral DEH underwent ITD and this case had complete vertigo control. The vertigo intensity, vertigo frequency, vertigo duration and the functional level scale after intratympanic injection was decreased significantly.

Keywords: Endolymphatic hydrops; dexamethasone; gentamicin; injection; inner ear.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Audiometry
  • Dexamethasone / administration & dosage
  • Dose-Response Relationship, Drug
  • Endolymphatic Hydrops / complications
  • Endolymphatic Hydrops / drug therapy*
  • Endolymphatic Hydrops / physiopathology
  • Female
  • Gentamicins / administration & dosage*
  • Glucocorticoids / administration & dosage
  • Humans
  • Injection, Intratympanic
  • Male
  • Middle Aged
  • Treatment Outcome
  • Vertigo / etiology
  • Vertigo / physiopathology
  • Vertigo / prevention & control
  • Vestibule, Labyrinth / drug effects
  • Vestibule, Labyrinth / physiopathology*
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Gentamicins
  • Glucocorticoids
  • Dexamethasone