Dexamethasone inner ear perfusion for the treatment of Meniere's disease: A prospective, randomized, double-blind, crossover trial

Objective: To investigate the benefits of intratympanic administration of d examethasone in the treatment of unilateral Meniere's disease, with particu lar attention to the symptoms of hearing loss and tinnitus. Study Design: A prospective, randomized, double-blind, crossover study comp aring improvements in hearing loss, tinnitus, aural Illness, and caloric ve stibular response secondary to intratympanic dexamethasone and sodium hyalu ronate injection versus placebo consisting of saline and sodium hyaluronate . Setting: A private otology/neurotology practice. Patients: Twenty patients diagnosed with either definite or probable Menier e's disease as defined by the American Academy of Otolaryngology Head and N eck Surgery Committee on Hearing and Equilibrium. All patients were greater than or equal to 21 years old and were not receiving any other form of tre atment for their Meniere's disease. Each patient's primary symptoms of conc ern were hearing loss, aural fullness, and roaring tinnitus. Interventions: Three consecutive daily administrations of intratympanic dex amethasone or placebo to the involved ear. Main Outcome Measures: Changes in audiometric pure-tone averages, speech re ception thresholds, caloric vestibular responses, scores on the tinnitus ha ndicap inventories, questionnaires, and telephone interview responses. Results: No significant changes were observed in any measured parameter. Pa tients were unable to consistently identify which medication was dexamethas one and which was placebo. Conclusions: Intratympanic administration of dexamethasone in a group of pa tients with unilateral Meniere's disease (Shea's stage IV) showed no benefi t over placebo for the treatment of hearing loss and tinnitus.