This prospective study investigated the role of simultaneous application of methylprednisolone and dexamethasone-soaked gelatin sponge to the endolymphatic sac surface and dexamethasone sponge to the short process of incus in 20 patients with refractory Ménière’s disease (MD) undergoing endolymphatic sac decompression. All procedures were performed under general anaesthesia. All patients were evaluated preoperatively with gadolinium-enhanced MRI for endolymphatic hydrops (EH) and vestibular aqueduct (VA) anatomy. The VA morphology and angular trajectory (ATVA) were also assessed with CT. The authors found that younger patients had more severe cochlear and vestibular EH. Additionally, the EH severity correlated with ATVA. Dual steroid therapy abolished vertigo in 95% at three days postop. The size of the VA and ATVA did not influence the outcomes. The authors conclude that dual steroid therapy helps to control vertigo in patients with refractory MD overcoming any anatomical abnormalities.
Does topical dual steroid therapy improve vertigo in refractory Ménière’s disease?
Reviewed by Gauri Mankekar
Dual-target corticosteroid therapy for refractory Ménière’s disease: influence of vestibular aqueduct patency and endotypes.
CONTRIBUTOR
Gauri Mankekar
Department of Otolaryngology-Head Neck Surgery, Louisiana State University Shreveport, Louisiana, USA.
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