Document Detail


Effects of endolymphatic sac drainage with steroids for intractable Meniere's disease: a long-term follow-up and randomized controlled study.
MedLine Citation:
PMID:  18520184     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Meniere's disease is a common inner ear disease with an incidence of 15 to 50 per 100,000 population. Since Meniere's disease is thought to be triggered by an immune insult to the inner ear, we examined intraendolymphatic sac application of steroids as a new therapeutic strategy for intractable Meniere's disease. STUDY DESIGN: Prospective randomized controlled study. METHODS: Between 1996 and 2005, we enrolled and assigned 197 intractable Meniere's patients to three groups in a randomized controlled trial: Group I (G-I)- patients who underwent endolymphatic sac drainage and steroid-instillation; Group II (G-II)-those who underwent endolymphatic sac drainage without steroid-instillation; and Group III (G-III)-those who declined endolymphatic sac drainage. Definitive spells and hearing in all three groups were determined for 2 to 7 years after treatment. RESULTS: According to the 1995 American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) criteria, 2-year results demonstrated that vertigo was completely controlled in 88.0% of patients in G-I (n = 100), 85.1% of patients in G-II (n = 47), and 8.0% in G-III (n = 50). Statistically, G-I = G-II>G-III. Hearing was improved in 49.0% of patients in G-I, 31.9% in G-II, and 6.0% in G-III (G-I>G-II>G-III). Results after 7 years showed that vertigo was completely controlled in 78.8% of patients in G-I, 79.2% in G-II, and 25.0% in G-III (G-I = G-II>G-III). Hearing improved in 36.5% of patients in G-I, 8.3% in G-II, and 0.0% in G-III (G-I>G-II = G-III). CONCLUSIONS: From non-surgical observation in G-III for at least 7 years after treatment, steroids instilled into endolymphatic sac in G-I patients significantly improved hearing in intractable Meniere's patients, more so than endolymphatic sac drainage without steroids in G-II patients.
Authors:
Tadashi Kitahara; Takeshi Kubo; Shin-ichi Okumura; Masaaki Kitahara
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  The Laryngoscope     Volume:  118     ISSN:  0023-852X     ISO Abbreviation:  Laryngoscope     Publication Date:  2008 May 
Date Detail:
Created Date:  2008-06-02     Completed Date:  2008-06-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8607378     Medline TA:  Laryngoscope     Country:  United States    
Other Details:
Languages:  eng     Pagination:  854-61     Citation Subset:  IM    
Affiliation:
Department of Otolaryngology, Osaka University, School of Medicine, Osaka, Japan. tkitahara@ent.med.osaka-u.ac.jp
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MeSH Terms
Descriptor/Qualifier:
Anti-Inflammatory Agents / pharmacology*,  therapeutic use*
Antidepressive Agents / pharmacology*,  therapeutic use*
Dexamethasone / pharmacology*,  therapeutic use*
Diazepam / pharmacology*,  therapeutic use*
Dimenhydrinate / pharmacology*,  therapeutic use*
Diuretics / pharmacology*,  therapeutic use*
Endolymphatic Sac / drug effects*
Female
Follow-Up Studies
Histamine H1 Antagonists / pharmacology*,  therapeutic use*
Humans
Male
Meniere Disease / drug therapy*
Middle Aged
Piperidines / pharmacology*,  therapeutic use*
Prospective Studies
Chemical
Reg. No./Substance:
0/Anti-Inflammatory Agents; 0/Antidepressive Agents; 0/Diuretics; 0/Histamine H1 Antagonists; 0/Piperidines; 439-14-5/Diazepam; 50-02-2/Dexamethasone; 523-87-5/Dimenhydrinate; 972-02-1/diphenidol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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