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Intratympanic therapy in Meniere's syndrome or disease: up to date evidence for clinical practice
Author(s) -
Syed M.I.,
Ilan O.,
Nassar J.,
Rutka J.A.
Publication year - 2015
Publication title -
clinical otolaryngology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.914
H-Index - 68
eISSN - 1749-4486
pISSN - 1749-4478
DOI - 10.1111/coa.12449
Subject(s) - medicine , vertigo , randomized controlled trial , meniere's disease , tinnitus , placebo , gentamicin , hearing loss , surgery , audiology , antibiotics , alternative medicine , pathology , microbiology and biotechnology , biology
Background Meniere's syndrome or disease ( MS /D) is typically characterised by episodic vertigo, aural fullness, tinnitus and fluctuating hearing loss. There are multiple options available for treatment with variation in consensus on the best intervention. Objective To evaluate the evidence on the efficacy of intratympanic therapies [steroids, gentamicin, antivirals and other therapies] on the frequency and severity of vertigo and other symptoms of MS /D. Search strategy A literature search was performed on AMED , EMBASE , HMIC , MEDLINE , Psyc INFO , BNI , CINAHL , HEALTH BUSINESS ELITE , CENTRAL and Cochrane Ear, Nose and Throat disorders group trials register using various Me SH . The search was restricted to English and human subjects, and the last date of search was December 2014. Selection criteria Randomised controlled trials of intratympanic therapies [steroids, gentamicin antivirals and latanoprost] versus a placebo or another treatment. Results We analysed 8 RCT 's comparing intratympanic steroids, gentamicin, ganciclovir (antiviral) and latanoprost versus another form of intratympanic treatment or placebo. Conclusions On the basis of 6 RCT 's ( n = 242), there is evidence to support the effectiveness of intratympanic steroids and gentamicin to control symptoms of vertigo in MS /D albeit with a risk of hearing loss with gentamicin. However, there was no consensus found on doses or treatment protocols. There was no evidence to support the use of other forms of intratympanic therapy (antivirals and latanoprost) in MS /D.