| Alternatives to systemic steroid therapy for refractory immune-mediated inner ear disease: A physiopathologic approach. | |
| | |
MedLine Citation:
|
PMID: 16802138 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
Immune-mediated inner ear disease (IMIED) is one of the few forms of reversible sensorineural hearing loss. Corticosteroids-responsive patients are usually associated with hearing improvement. Due to the long clinical course of IMIED that frequently present recurrences (hearing loss and vertigo), alternatives to corticosteroids such as methotrexate and recently TNF-alpha blockers have been proposed. Likewise new procedures for delivering corticosteroids to the inner ear have been developed. The aim of this article is to assess the efficacy of methotrexate and transtympanic 6-methylprednisolone in refractory IMIED. From a database of 200 patients affected by IMIED, 16 selected patients with refractory disease were included in the present study. Five patients were treated with methotrexate and 11 by means of transtympanic injection of 6-methylprednisolone. All patients treated with methotrexate had an improvement in their vestibular symptoms. However, hearing loss did not improve. Most patients treated with local 6-methylprednisolone (68.75%) showed an improvement in hearing loss and vestibular symptoms. Methotrexate has been shown to be ineffective in maintaining long-term remissions of hearing relapses although patients presented an improvement in vestibular symptoms. However, transtympanic 6-methylprednisolone has been shown to be a safe, easy and useful therapy in refractory IMIED and it may actually become the first-line treatment for these patients based on the existence of glucocorticoid receptors and the possible targets of immune-mediated damage within the inner ear. |
| | |
Authors:
|
José Ramón García-Berrocal; Andrés Ibáñez; Antonio Rodríguez; José Angel González-García; José María Verdaguer; Almudena Trinidad; Rafael Ramírez-Camacho |
Related Documents
:
|
21599718 - Effects of alcoholism and continued abstinence on brain volumes in both genders. 8719508 - Dizziness of suspected cervical origin distinguished by posturographic assessment of hu... 309268 - A prospective study of gentamicin ototoxicity. 2049368 - Abnormal visual-vestibular interaction and smooth pursuit tracking in psychosis: implic... 22481448 - Different models in predicting the short-term prognosis of patients with hepatitis b vi... 11129228 - Renal function and structure in subacute hepatic failure. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't Date: 2006-06-27 |
Journal Detail:
|
Title: European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery Volume: 263 ISSN: 0937-4477 ISO Abbreviation: Eur Arch Otorhinolaryngol Publication Date: 2006 Nov |
Date Detail:
|
Created Date: 2006-09-21 Completed Date: 2007-03-20 Revised Date: 2007-11-15 |
Medline Journal Info:
|
Nlm Unique ID: 9002937 Medline TA: Eur Arch Otorhinolaryngol Country: Germany |
Other Details:
|
Languages: eng Pagination: 977-82 Citation Subset: IM |
Affiliation:
|
Servicio de Otorrinolaringología, Hospital Universitario Puerta de Hierro, San Martin de Porres 4, 28035 Madrid, Spain. jrgarciab@yahoo.com |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Administration, Oral Adolescent Adult Autoimmune Diseases / complications* Dose-Response Relationship, Drug Drug Administration Schedule Female Glucocorticoids / administration & dosage* Hearing Loss, Sensorineural / drug therapy*, immunology, physiopathology Humans Immunosuppressive Agents / administration & dosage* Injections Male Methotrexate / administration & dosage* Methylprednisolone / administration & dosage* Middle Aged Retrospective Studies Round Window, Ear |
| Chemical | |
Reg. No./Substance:
|
0/Glucocorticoids; 0/Immunosuppressive Agents; 59-05-2/Methotrexate; 83-43-2/Methylprednisolone |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: The second cysteine protease inhibitor, EhICP2, has a different localization in trophozoites of Enta...
Next Document: The role of sleep position in obstructive sleep apnea syndrome.