DEXAMETHASONE PERFUSION OF THE LABYRINTH PLUS INTRAVENOUS DEXAMETHASONE FOR MENIERES-DISEASE

Recent clinical and laboratory evidence indicates that Meniere's disea se is an immune-mediated disease. Dexamethasone perfusion of the inner ear through the round window plus intravenous dexamethasone often wil l stop the dizzy spells, reduce the fullness and low-frequency tinnitu s, and sometimes improve the hearing in patients with Meniere's diseas e. The dexamethasone must act mostly on the endolymphatic sac and, to a lesser extent, on the stria vascularis and spiral ligament, the know n targets of immune response in the inner ear, to reduce the endolymph atic hydrops and restore the fluid dynamics of the endolymph. Despite the good results with streptomycin perfusion, the number of patients w ith further hearing loss is large, so dexamethasone perfusion with int ravenous dexamethasone should be tried first. The initial response to dexamethasone perfusion plus intravenous dexamethasone has been very g ood, with very little risk of further hearing loss, and it holds great promise for the future.