■ OBJECTIVE: To evaluate the efficacy of intratympanic dexamethasone perfusion for vertigo control and hearing improvement in patients with Meniere’s disease (MD).

■ METHODS: A retrospective chart review was performed in patients with MD who underwent intratympanic dexamethasone perfusion in a tertiary referral center The AAO/HNS criteria were used for diagnosis of MD. Patients who previously failed management with a diuretic and low-salt diet underwent intratympanic perfusion of 0.4 ml of 24 mg/ml of dexamethasone into the postero-inferior aspect of the tympanic membrane . Outcomes were determined by subjective assessment of vertigo control and by audiometric evaluation at the first post-perfusion visit, 4 to 6 weeks later (short term results) and at least 12 months later (long term results).

■ RESULTS: Between January 2000 and February 2005, 36 patients (23 women and 13 men) with mean age 58 years (Range 28 - 85 years) with MD underwent intratympanic dexamethasone 24mg/ml perfusion. Mean follow-up was 30 months (Range 12 -48 months). No middle ear or tympanic membrane complications were identified. Audiometric results were available for comparison in 30 patients. In the short term, complete cessation of vertigo was reported by 26 of 36 patients (72.2%). Six patients demonstrated a greater than 10 db improvement in PTA, while 4 patients had a decrease in hearing of more than 10 db. Six patients had an increase in speech discrimination score (SDS) of at least 15% and in 4 patients SDS was decreased over 15%. In the long-term 12 patients (33.3%) achieved vertigo control, 5 patients demonstrated a greater than 10 db improvement in PTA, while 7 patients had a decrease in hearing of more than10 db. Two patients had an increase in SDS of at least 15% and in 4 patients SDS decreased by 15%.

■ CONCLUSIONS: Intratympanic dexamethasone perfusion may provide temporary relief of symptoms of MD, especially in management of vertigo. In the short term vertigo control was achieved in more than 2/3 of the study population, while 1/3 of patients maintained vertigo control at long-term follow-up.