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 60 years. 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 0.5 ml/4 mg per mm directly in antero-superior quadrant of tympanic membrane. These injections were repeated once a week for 4 weeks. Results were evaluated by using audiometric and tympanometric measurements 1 and 3 months after the treatments. Audiometric measurement shows that 9.91 dB improvement in the mean air-bone gap 15.17 dB in air conduction (AC) pure-tone averages (PTA) and 5.25 dB bone conduction (BC) PTA. But the control group data showed only 2 dB improvement in the mean air-bone gap, 3 dB AC-PTA and 1.36 dB 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.

Assessment of Grommet Tube Insertion versus Myringotomy with Intratympanic Steroid Injection in Treatment of Otitis Media with Effusion

“…When used to treat otitis media with effusion or chronic Eustachian tube dysfunction, ITD injections into the middle ear are well tolerated and produced desirable results. There have been no adverse effects, such as perforation of the tympanic membrane or sensorineural hearing loss (11) .…”

Serous otitis media: Clinical and therapeutic considerations, including dexamethasone (C22H29FO5) intratympanic injection

“…DXM has been used due to good local dispersion with the ability to inhibit inflammation and reduce edema, satisfactory absorption in the middle ear and no side effects locally and generally. Previous findings also found DXM to be effective in the reduction of granulation tissue, more than antibiotic therapy alone ( 17 ). Mucosal hypertrophy reduction and possible permeabilization improvement through ET is expected.…”

RNA Sequencing and Pathways Analyses of Middle Ear Epithelia From Patients With Otitis Media

“…Oral steroids have been shown to lead to quicker resolution of acute OM when used in conjunction with antibiotics 69 . Intra‐tympanic dexamethasone has been shown to be effective in treating patients with COME 70 . Our laboratory recently developed novel dual‐agent antibiotic and dexamethasone cationic nanoparticle formulations for treatment of acute and chronic OM and is examining its enhanced penetration across the intact tympanic membrane using ex vivo and in vivo models (NIH NIAID 5R21AI147607‐02).…”