Intratympanic Injections of Dexamethasone in Delayed Endolymphatic Hydrops: A Prospective Clinical Study

Morgan, Ashraf Elsayed; Ismail, Elshahat Ibrahem; Ashraf, Bassem

doi:10.1159/000486373

Cited by 4 publications

(3 citation statements)

References 15 publications

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“…Steroid therapy via IT delivery may be considered an alternative for oral steroid therapy 258,288,298,299 and IT gentamicin therapy 279–282 . Oral steroids have significant risk of side effects, 99 , 298 and patients with usable hearing—class A or B as defined by AAO‐HNSF guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma) 300 —may be hesitant to undergo an ablative inner ear therapy with a known potential for hearing loss.…”

Section: Guideline Key Action Statementsmentioning

confidence: 99%

“…Specifically, a recent review of inner ear pharmacokinetics noted that commonly used dexamethasone sodium phosphate appears to be ill-suited for use in IT therapy, and there are very few data regarding the inner ear pharmacokinetics of commonly used methylprednisolone sodium succinate. 297 Steroid therapy via IT delivery may be considered an alternative for oral steroid therapy 258,288,298,299 and IT gentamicin therapy. [279][280][281][282] Oral steroids have significant risk of side effects, 99,298 and patients with usable hearing-class A or B as defined by AAO-HNSF guidelines for the evaluation of hearing preservation in acoustic neuroma (vestibular schwannoma) 300 -may be hesitant to undergo an ablative inner ear therapy with a known potential for hearing loss.…”

Section: Supporting Textmentioning

confidence: 99%

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Clinical Practice Guideline: Ménière’s Disease

Basura

Adams

Monfared

et al. 2020

Otolaryngol.--head neck surg.

182

207

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Objective Ménière’s disease (MD) is a clinical condition defined by spontaneous vertigo attacks (each lasting 20 minutes to 12 hours) with documented low- to midfrequency sensorineural hearing loss in the affected ear before, during, or after one of the episodes of vertigo. It also presents with fluctuating aural symptoms (hearing loss, tinnitus, or ear fullness) in the affected ear. The underlying etiology of MD is not completely clear, yet it has been associated with inner ear fluid (endolymph) volume increases, culminating in episodic ear symptoms (vertigo, fluctuating hearing loss, tinnitus, and aural fullness). Physical examination findings are often unremarkable, and audiometric testing may or may not show low- to midfrequency sensorineural hearing loss. Conventional imaging, if performed, is also typically normal. The goals of MD treatment are to prevent or reduce vertigo severity and frequency; relieve or prevent hearing loss, tinnitus, and aural fullness; and improve quality of life. Treatment approaches to MD are many and typically include modifications of lifestyle factors (eg, diet) and medical, surgical, or a combination of therapies. Purpose The primary purpose of this clinical practice guideline is to improve the quality of the diagnostic workup and treatment outcomes of MD. To achieve this purpose, the goals of this guideline are to use the best available published scientific and/or clinical evidence to enhance diagnostic accuracy and appropriate therapeutic interventions (medical and surgical) while reducing unindicated diagnostic testing and/or imaging.

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Section: Guideline Key Action Statementsmentioning

confidence: 99%

Section: Supporting Textmentioning

confidence: 99%

Clinical Practice Guideline: Ménière’s Disease

Basura

Adams

Monfared

et al. 2020

Otolaryngol.--head neck surg.

182

207

View full text Add to dashboard Cite

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“…In some cases, conservative surgeries such as endolymphatic sac decompression and sacculo cochleostomy are preferable ere labyrinth degenerative surgeries. However, the effects of these conservative surgeries on vertigo attacks are not satisfactory [2, 25].…”

Section: Discussionmentioning

confidence: 99%

Evaluation of Patients with Delayed Endolymphatic Hydrops by Videonystagmography, Vestibular-Evoked Myogenic Potentials, and Electrocochleography

Yazdani

Rahmaty

Mousavi

et al. 2021

ORL

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Introduction: The categorization of delayed endolymphatic hydrops (DEH) based on the ear which produces vertigo may sometimes cause misdiagnosis. Objectives: The aim of this study was investigating the vestibular-evoked myogenic potentials (VEMPs), electrocochleography (ECoG), and videonystagmography (VNG) in cases with DEH to determine the ear that originates symptoms. Methods: In this cross-sectional study, 34 patients – 20 males and 14 females – with profound unilateral sensorineural deafness and vertigo attacks were recruited and evaluated by the ECoG, VNG, and VEMPs tests. Results: The average age was around 43; the summating potential/action potential was abnormal in 29.4% of patients in their normal auditive ear. In 32.4, 17.6, and 50% of cases with a deaf ear, absent, normal, and abnormal VEMPs results were sequentially observed, respectively. In normal-hearing ears, absent, normal, and abnormal VEMPs were observed in 23.5, 50, and 26.5%, respectively. In the normal-hearing ear, the distribution of abnormal VEMPs was 26.5%, and in the deaf ear, this parameter was abnormal in 50% of the opposite ear (p value = 0.00021). In the VNG test, among patients with a normal-hearing ear, results in 27 and 7 patients were sequentially normal and hypofunction. Conclusion and Significance: The probability of a hypofunction VNG test in a normal-hearing ear might be greater when the VEMPs results of the contralateral deaf ear are normal. In patients with a normal-hearing ear, the distribution of abnormal VEMPs in the contralateral deaf ear is greater, although the intact side may also manifest abnormality in VEMPs tests. The initial evaluation should begin in a deaf ear as well as for the normal-hearing ear ere utilizing ablation surgery.

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