Transtympanic dexamethasone application in Meniere's disease: an alternative treatment for intractable vertigo

The aetiology of Meniere's disease still remains unknown and its therapy is therefore empirical. As a result of immunological abnormalities demonstrat ed, steroids are commonly used in Meniere's disease. The place of topical s teroids is still controversial. In this investigation topical dexamethasone is applied for three months through a ventilation tube in patients with in tractable vertigo. The results showed that this treatment controls vertigo in 72 per cent of cases. No patient was worse than before treatment. Only i n 17 per cent of the patients was there an increase in hearing level. When compared to the reports which used only tympanostomy tubes, this procedure seems to have a placebo effect with minimal harmful effects. It appears tha t transtympanic dexamethasone application is a good alternative to vestibul ar nerve section. Topical treatment may be sufficient in most patients. Sys temic treatment may be used in patients where topical treatment fails.